Healthcare Provider Details

I. General information

NPI: 1811801350
Provider Name (Legal Business Name): ALIYAH LASKEY FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/01/2026
Last Update Date: 10/01/2026
Certification Date: 10/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1105 6TH ST
TRAVERSE CITY MI
49684-2345
US

IV. Provider business mailing address

1428 MARVIN GARDENS DR
TRAVERSE CITY MI
49696-9487
US

V. Phone/Fax

Practice location:
  • Phone: 231-935-5000
  • Fax:
Mailing address:
  • Phone: 231-429-2154
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number4704402955
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: