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NPI 1639613730

NPI 1639613730 : ALYSON VIGNEAU FNP-C : DEARBORN, MI

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General NPI Number Information
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    NPI Number           |    1639613730
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    Entity Type          |    Individual 
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    Provider Name        |    ALYSON VIGNEAU FNP-C
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    12/07/2016
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    Last Update Date     |    06/26/2025
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Provider Practice Location Address
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    Address Line         |    5111 AUTO CLUB DR FL 3 
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    City                 |    DEARBORN
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    State                |    MI
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    Zip                  |    48126-2749
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    Country              |    US
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    Telephone            |    313-317-2000
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    1 FORD PL STE 3A 
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    City                 |    DETROIT
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    State                |    MI
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    Zip                  |    48202-3450
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    Country              |    US
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    Telephone            |    313-874-4553
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    Fax                  |    517-803-2135
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    363LF0000X
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    Taxonomy Name        |    Family Nurse Practitioner
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    License Number       |    AP9712
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    License Number State |    AZ
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Taxonomy #2
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    Taxonomy Code        |    363LP0808X
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    Taxonomy Name        |    Psychiatric/Mental Health Nurse Practitioner
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    License Number       |    4704284982
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    License Number State |    MI
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