Individual
ALLYSSA BODDY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP-C
Contact information
Practice address
35700 WARREN RD STE C, WESTLAND, MI 48185-3808
(313) 437-8427
(313) 437-8429
Mailing address
9029 PARDEE RD, TAYLOR, MI 48180-2755
(313) 437-8427
(313) 447-8429
Taxonomy
Speciality
Code
Description
License number
State
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
4704292285
MI
363LF0000X
Family Nurse Practitioner
Primary
4704292285
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4704292285NSA180VY
—
MI
Enumeration date
09/21/2018
Last updated
08/07/2026
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