Provider Demographics
NPI:1043670730
Name:MCAFEE, ALISHA DUFFY (OD)
Entity Type:Individual
Prefix:MRS
First Name:ALISHA
Middle Name:DUFFY
Last Name:MCAFEE
Suffix:
Gender:F
Credentials:OD
Other - Prefix:MS
Other - First Name:ALISHA
Other - Middle Name:CHRISTINE
Other - Last Name:DUFFY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:14947 80TH PL N
Mailing Address - Street 2:
Mailing Address - City:MAPLE GROVE
Mailing Address - State:MN
Mailing Address - Zip Code:55311-2160
Mailing Address - Country:US
Mailing Address - Phone:763-313-6330
Mailing Address - Fax:
Practice Address - Street 1:1500 109TH AVE NE
Practice Address - Street 2:
Practice Address - City:BLAINE
Practice Address - State:MN
Practice Address - Zip Code:55449-4670
Practice Address - Country:US
Practice Address - Phone:763-354-1003
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-02-24
Last Update Date:2016-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN3458152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist