Provider Demographics
NPI:1194575712
Name:BIRKEMEIER, ALISHA JOY
Entity type:Individual
Prefix:
First Name:ALISHA
Middle Name:JOY
Last Name:BIRKEMEIER
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 1:23913 TOWNSHIP ROAD 52
Mailing Address - Street 2:
Mailing Address - City:ADA
Mailing Address - State:OH
Mailing Address - Zip Code:45810-9301
Mailing Address - Country:US
Mailing Address - Phone:740-360-7757
Mailing Address - Fax:
Practice Address - Street 1:136 W CENTER ST
Practice Address - Street 2:
Practice Address - City:MARION
Practice Address - State:OH
Practice Address - Zip Code:43302-3704
Practice Address - Country:US
Practice Address - Phone:740-751-6380
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-26
Last Update Date:2024-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNP.0036114363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health