Provider Demographics
NPI:1083258412
Name:KEIZER, ALAINA (PA-C)
Entity Type:Individual
Prefix:
First Name:ALAINA
Middle Name:
Last Name:KEIZER
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:ALAINA
Other - Middle Name:
Other - Last Name:MACKOOL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:31360 NORTHWESTERN HWY
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48334-2523
Mailing Address - Country:US
Mailing Address - Phone:248-855-3300
Mailing Address - Fax:
Practice Address - Street 1:31360 NORTHWESTERN HWY
Practice Address - Street 2:
Practice Address - City:FARMINGTON HILLS
Practice Address - State:MI
Practice Address - Zip Code:48334-2523
Practice Address - Country:US
Practice Address - Phone:248-855-3300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-10-29
Last Update Date:2023-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5601009697363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant