Provider Demographics
NPI:1760293955
Name:ALANIZ, TRESA
Entity type:Individual
Prefix:MRS
First Name:TRESA
Middle Name:
Last Name:ALANIZ
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 1:9488 BRISTOL RD
Mailing Address - Street 2:
Mailing Address - City:SWARTZ CREEK
Mailing Address - State:MI
Mailing Address - Zip Code:48473-8592
Mailing Address - Country:US
Mailing Address - Phone:810-223-1605
Mailing Address - Fax:
Practice Address - Street 1:9488 BRISTOL RD
Practice Address - Street 2:
Practice Address - City:SWARTZ CREEK
Practice Address - State:MI
Practice Address - Zip Code:48473-8592
Practice Address - Country:US
Practice Address - Phone:810-223-1605
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-16
Last Update Date:2025-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI00000000363LS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LS0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerSchool