Provider Demographics
NPI:1851054605
Name:LICHTENFELT, ALEXANDRIA (LM CPM)
Entity Type:Individual
Prefix:
First Name:ALEXANDRIA
Middle Name:
Last Name:LICHTENFELT
Suffix:
Gender:F
Credentials:LM CPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:644 PINE ST
Mailing Address - Street 2:
Mailing Address - City:LAPEER
Mailing Address - State:MI
Mailing Address - Zip Code:48446-2171
Mailing Address - Country:US
Mailing Address - Phone:810-610-7278
Mailing Address - Fax:
Practice Address - Street 1:644 PINE ST
Practice Address - Street 2:
Practice Address - City:LAPEER
Practice Address - State:MI
Practice Address - Zip Code:48446-2171
Practice Address - Country:US
Practice Address - Phone:810-610-7278
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-19
Last Update Date:2021-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI7601000086176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes176B00000XOther Service ProvidersMidwifeGroup - Single Specialty