MEDICARE: ALYSSA LEA DILLEY

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
1	374J00000X	Doula		MI
2	363L00000X	Nurse Practitioner	4704266593	MI

General Provider Information

NPI Number	:	1740153410
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALYSSA LEA DILLEY

Provider Business Mailing Address
First Line	:	17817 MOHAWK DR
Second Line	:
City	:	SPRING LAKE
State	:	MI
Zip	:	49456-9120
Country	:	US
Telephone Number	:	231-750-3033
Fax Number	:

Provider Business Practice Location Address
First Line	:	17817 MOHAWK DR
Second Line	:
City	:	SPRING LAKE
State	:	MI
Zip	:	49456-9120
Country	:	US
Telephone Number	:	231-750-3033
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/27/2025
Last Update Date	:	02/05/2026

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Directions to “ ALYSSA LEA DILLEY ” Practice Location

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