MARISSA HENDRICK FNP-C
NPI 1053243055
Nurse Practitioner - Family in South Lyon, MI
Active since June 02, 2026
About Marissa Hendrick Fnp-c NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
MARISSA HENDRICK FNP-C (NPI 1053243055) is an individual family provider in South Lyon, Michigan, licensed in Michigan (4704346080) and active in the NPI registry since June 2026.
NPPES Registry Identity
NPI1053243055
Entity TypeIndividualFemale
Primary Taxonomy363LF0000X
Provider Legal NameMARISSA HENDRICKCredential: FNP-C
Location Address23026 VALERIE STSouth Lyon, MI 48178-1632
Mailing Address23026 Valerie StSouth Lyon, MI 48178-1632 · (248) 931-0686
Phone(248) 931-0686
Sole ProprietorNo
Enumeration DateJune 2, 2026
NPPES CertifiedJune 2, 2026
✔ NPI 1053243055 is a valid, active identifier and passes the ISO check-digit test.
Specialties & Licenses
★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
License✔ Licensed in MI · 4704346080
23026 VALERIE ST, South Lyon, MI 48178
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1053243055, enumerated as an "individual" on June 02, 2026.
The provider is located at 23026 VALERIE ST SOUTH LYON, MI 48178 and the phone number is (248) 931-0686.
Nurse Practitioner with taxonomy code 363LF0000X and a focus in Family.
