ALYSSA CLARK DNP FNP-BC NPI 1184293805

NPI Information

NPI: 1184293805
Provider Name: ALYSSA CLARK, DNP, FNP-BC
Classification: Nurse Practitioner - 363LF0000X
Entity Type: Individual

Specialization: Family

PECOS Registration: Yes

Address:
24675 LAHSER RD
SOUTHFIELD, MI
ZIP 48033
Phone: (586) 453-8682
Get Directions

Alyssa Clark, DNP, FNP-BC is a family nurse practitioner in Southfield, MI. Alyssa Clark, DNP, FNP-BC NPI is 1184293805. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

24675 LAHSER RD
SOUTHFIELD, MI
ZIP 48033-238
Phone: (586) 453-8682

The NPI 1184293805 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 6/18/2021 and was last updated on 6/18/2021.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363LF0000X	Nurse Practitioner	Family	4704334727	MICHIGAN	Yes
2	363LF0000X	Nurse Practitioner	Family	4704334727NSA2109N	MICHIGAN	No

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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