Individual
ALISSA SOUTHWAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
46600 ROMEO PLANK RD, SUITE #4, MACOMB, MI 48044-5741
(586) 228-5437
Mailing address
45726 PENTWATER DR, MACOMB, MI 48044-4237
(586) 382-5711
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
4704284597
MI
Other
Enumeration date
04/27/2016
Last updated
07/25/2022
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