Healthcare Provider Details

I. General information

NPI: 1821508284
Provider Name (Legal Business Name): ALEXA NICOLE HARKEMA PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/11/2017
Last Update Date: 01/07/2026
Certification Date: 01/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11800 E 12 MILE RD
WARREN MI
48093-3472
US

IV. Provider business mailing address

35689 HUNTER AVE
WESTLAND MI
48185-6662
US

V. Phone/Fax

Practice location:
  • Phone: 586-576-4904
  • Fax: 586-573-5953
Mailing address:
  • Phone: 313-623-9592
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number5601008409
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: