Individual
ALYSSA KNAACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
22101 MOROSS RD, DETROIT, MI 48236-2148
(248) 321-8967
Mailing address
42489 WILLSHARON ST, STERLING HEIGHTS, MI 48314-3077
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
4704299654
MI
367500000X
Certified Registered Nurse Anesthetist
Primary
4704299654
MI
Other
Enumeration date
07/23/2018
Last updated
06/12/2020
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