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NPI Code Detail

MEDICARE: ALEXA DALLI APRN, PMHNP-BC

MEDICARE: ALEXA DALLI APRN, PMHNP-BC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LP0808XPsychiatric/Mental Health Nurse Practitioner4704325802MI
2163W00000XRegistered Nurse4704325802MI

General Provider Information

NPI Number : 1972185130
Entity Type Code : Individual
Provider Name (Legal Business Name) : ALEXA DALLI APRN, PMHNP-BC
Provider Business Mailing Address
First Line : 220 S MAIN ST
Second Line :
City : ROYAL OAK
State : MI
Zip : 48067-2676
Country : US
Telephone Number : 248-216-4704
Fax Number :
Provider Business Practice Location Address
First Line : 220 S MAIN ST
Second Line :
City : ROYAL OAK
State : MI
Zip : 48067-2676
Country : US
Telephone Number : 248-216-4704
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/26/2021
Last Update Date : 02/12/2026

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