Individual provider · Type 1 NPI

Natisha Irene Clark

Primary Care Nurse Practitioner · West Bloomfield, MI

NPI number 1871957985 Active

Practice location

6777 W Maple Rd
West Bloomfield, MI 48322-3013

Fax (313) 876-1305

Mailing address

1 Ford Pl Ste 3A
Detroit, MI 48202-3450

Other practice locations

  • 15150 Fort St, Southgate, MI 48195-1302 · (734) 282-4800

Specialties and licenses

TaxonomyCodeLicense
Registered Nurse 163W00000X4704278418 (MI)
Primary Care Nurse Practitioner Primary 363LP2300X4704278418 (MI)

Primary Care Nurse Practitioner: Definition to come...

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About NPI 1871957985

Natisha Irene Clark's National Provider Identifier is 1871957985, issued on Apr 6, 2016. The primary taxonomy on file is Primary Care Nurse Practitioner (363LP2300X), and the practice location is in West Bloomfield, MI. The record was last updated on Nov 10, 2022.