Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363L00000X | Nurse Practitioner | 4704273044 | MI |
Y | 363LF0000X | Nurse Practitioner - Family Medicine | 4704273044 | MI |
NPI | 1003354952 |
---|---|
Provider Name | Mrs. Alexandra Noelle Hayosh |
First Address | Shelby Township, MI 48315-3848 |
Second Address | Royal Oak, MI 48073-6712 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/02/2017 |
Last Update Date | 20/04/2021 |