Provider Demographics
NPI:1356905962
Name:YOUSIF, ALISON SANDRA (FNP-BC)
Entity type:Individual
Prefix:
First Name:ALISON
Middle Name:SANDRA
Last Name:YOUSIF
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:ALISON
Other - Middle Name:SANDRA
Other - Last Name:SINAWE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:14548 ISLAND DR
Mailing Address - Street 2:
Mailing Address - City:STERLING HEIGHTS
Mailing Address - State:MI
Mailing Address - Zip Code:48313-2212
Mailing Address - Country:US
Mailing Address - Phone:248-410-0499
Mailing Address - Fax:
Practice Address - Street 1:215 E AUBURN RD
Practice Address - Street 2:
Practice Address - City:ROCHESTER HILLS
Practice Address - State:MI
Practice Address - Zip Code:48307-5260
Practice Address - Country:US
Practice Address - Phone:248-410-0499
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-04-29
Last Update Date:2024-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704317803363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1356905962OtherMEDICAID
MI1356905962Medicaid