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NPI Code Detail

MEDICARE: ALYSSA ANN MANRY FNP-C

MEDICARE:   ALYSSA ANN MANRY  FNP-C
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LF0000XFamily Nurse Practitioner4704335676MI

General Provider Information

NPI Number : 1386468338
Entity Type Code : Individual
Provider Name (Legal Business Name) : ALYSSA ANN MANRY FNP-C
Provider Business Mailing Address
First Line : 801 ROSEHILL RD
Second Line :
City : JACKSON
State : MI
Zip : 49202-1762
Country : US
Telephone Number : 517-212-2008
Fax Number : 517-212-9023
Provider Business Practice Location Address
First Line : 565 PROGRESS ST STE B
Second Line :
City : WEST BRANCH
State : MI
Zip : 48661-8601
Country : US
Telephone Number : 989-941-3290
Fax Number : 989-488-4570
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/14/2024
Last Update Date : 09/10/2025

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Directions to “ ALYSSA ANN MANRY FNP-C” Practice Location

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