Individual
ALYSSA CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DNP, FNP-BC
Contact information
Practice address
24675 LAHSER RD, SOUTHFIELD, MI 48033-3238
(586) 453-8682
Mailing address
53075 PIMPERNIL LN, CHESTERFIELD, MI 48051-1779
(586) 453-8682
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
4704334727
MI
363LF0000X
Family Nurse Practitioner
4704334727NSA2109N
MI
Other
Enumeration date
06/18/2021
Last updated
11/10/2025
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