Provider Demographics
NPI:1386354991
Name:DENNY, ALEXIS (PA-C)
Entity type:Individual
Prefix:
First Name:ALEXIS
Middle Name:
Last Name:DENNY
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:42621 GARFIELD RD STE 108
Mailing Address - Street 2:
Mailing Address - City:CLINTON TWP
Mailing Address - State:MI
Mailing Address - Zip Code:48038-5031
Mailing Address - Country:US
Mailing Address - Phone:586-263-3312
Mailing Address - Fax:
Practice Address - Street 1:42621 GARFIELD RD STE 108
Practice Address - Street 2:
Practice Address - City:CLINTON TOWNSHIP
Practice Address - State:MI
Practice Address - Zip Code:48038-5031
Practice Address - Country:US
Practice Address - Phone:586-263-3312
Practice Address - Fax:586-263-5311
Is Sole Proprietor?:Yes
Enumeration Date:2022-12-05
Last Update Date:2025-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5601011490363AM0700X, 363A00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine