Healthcare Provider Details

I. General information

NPI: 1427385905
Provider Name (Legal Business Name): KAREN ALFONSETTI
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/04/2009
Last Update Date: 01/05/2024
Certification Date: 01/05/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

44250 DEQUINDRE RD
STERLING HEIGHTS MI
48314-1002
US

IV. Provider business mailing address

16154 WROTHAM CT
CLINTON TWP MI
48038-4090
US

V. Phone/Fax

Practice location:
  • Phone: 855-863-8761
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number4704138684
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: