Provider Demographics
NPI:1003354952
Name:HAYOSH, ALEXANDRA NOELLE (NP-C)
Entity Type:Individual
Prefix:MRS
First Name:ALEXANDRA
Middle Name:NOELLE
Last Name:HAYOSH
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:ALEXANDRA
Other - Middle Name:NOELLE
Other - Last Name:MILES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:26901 BEAUMONT BLVD STE 3D
Mailing Address - Street 2:
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48033-3849
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:586-566-7850
Practice Address - Street 1:3601 W 13 MILE RD
Practice Address - Street 2:
Practice Address - City:ROYAL OAK
Practice Address - State:MI
Practice Address - Zip Code:48073-6712
Practice Address - Country:US
Practice Address - Phone:248-898-4021
Practice Address - Fax:218-898-1473
Is Sole Proprietor?:No
Enumeration Date:2017-02-10
Last Update Date:2022-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704273044363L00000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner