Provider Demographics
NPI:1003274283
Name:PUNCHES, ALEXIS MAE (NP)
Entity Type:Individual
Prefix:MS
First Name:ALEXIS
Middle Name:MAE
Last Name:PUNCHES
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:ALEXIS
Other - Middle Name:
Other - Last Name:PUNCHES
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:NP
Mailing Address - Street 1:3621 SOUTH STATE STREET
Mailing Address - Street 2:700 KMS PLACE
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48108
Mailing Address - Country:US
Mailing Address - Phone:734-936-2047
Mailing Address - Fax:
Practice Address - Street 1:1500 EAST MEDICAL CENTER DR
Practice Address - Street 2:12TH FLOOR C.S. MOTT CHILDRENS HOSPITAL RM 525
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48109-4280
Practice Address - Country:US
Practice Address - Phone:734-764-5302
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-02-03
Last Update Date:2016-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704239782363LC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LC0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerCritical Care Medicine