ELLICE CLARK

DETROIT, MI
NPI1679287395
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy367500000X Nurse Anesthetist, Certified Registered
(Licence: MI  4704345479)
Additional Taxonomies163W00000X Registered Nurse
(Licence: MI  4704345479)
Enumeration Date2023-01-09
Last Update Date2024-11-21
Business Address
ELLICE CLARK
4001 W MCNICHOLS RD
DETROIT, MI 48221-3038
Phone number: 313-993-1245
Mailing Address
ELLICE CLARK
13032 WOODRIDGE CIR
PLYMOUTH, MI 48170-3892
Phone number: 989-295-4067