Provider Demographics
NPI:1477302446
Name:MCROBERTS, ALYSON LOUISE
Entity type:Individual
Prefix:
First Name:ALYSON
Middle Name:LOUISE
Last Name:MCROBERTS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2538 MASON LN
Mailing Address - Street 2:
Mailing Address - City:HOLT
Mailing Address - State:MI
Mailing Address - Zip Code:48842-2137
Mailing Address - Country:US
Mailing Address - Phone:517-285-9930
Mailing Address - Fax:
Practice Address - Street 1:453 E EDGEWOOD BLVD APT C
Practice Address - Street 2:
Practice Address - City:LANSING
Practice Address - State:MI
Practice Address - Zip Code:48911-5845
Practice Address - Country:US
Practice Address - Phone:517-282-7926
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-14
Last Update Date:2024-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide