Healthcare Provider Details

I. General information

NPI: 1447825989
Provider Name (Legal Business Name): YOUSSEF MAKKI NURSE PRACTITIONER
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/26/2021
Last Update Date: 06/23/2026
Certification Date: 06/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7300 DIXIE HWY STE 100
CLARKSTON MI
48346-5102
US

IV. Provider business mailing address

3815 PELHAM ST
DEARBORN MI
48124-3852
US

V. Phone/Fax

Practice location:
  • Phone: 248-922-2300
  • Fax: 248-922-2304
Mailing address:
  • Phone: 313-722-4683
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number4704318908NSA210D2
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: