Boddy, Allyssa
Boddy, Allyssa is an sole proprietor health care provider with primary practice located at 100 W West Maple Rd , Walled Lake MI 48390-3402. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Boddy, Allyssa can be contacted via phone (866) 389-2727.Contact Information
Primary practice address
100 W West Maple Rd
Walled Lake MI 48390-3402
Phone: (866) 389-2727
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Family | 363LF0000X | 4704292285 | Michigan |
Profile Details
| NPI number | 1720562010 |
|---|---|
| LBN Legal business name | Boddy, Allyssa |
| Credentials | NP-C |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Sep 21st, 2018 |
| Last updated | Jun 30th, 2022 - about 2 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1720562010 | NPPES |
| Michigan | MEDICAID | 4704292285NSA180VY |
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