Doctor profile · Federal record
Dr. Ellice Clark
Certified Registered Nurse Anesthetist (CMS: Certified Registered Nurse Anesthetist (CRNA)) · Registered Nurse · Detroit, MI
- NPI 1679287395
- 2 yrs in practice
- Female
- Group practice
- No sanctions
Practice & contact
- Primary practice
-
4001 W McNichols RD
Detroit, MI 482213038
(313) 993-1245 - Mailing address
-
13032 Woodridge Cir
Plymouth, MI 481703892
Credentials & registration
- NPI registered
- January 2023 — 3 yrs on file
- Profile last updated
- November 21, 2024
- Year of graduation
- 2024 — 2 yrs since
- Specialty taxonomy
- 367500000X — NUCC code
- State license (1)
- Michigan #4704345479
Federal sanctions & exclusions
No sanctions, exclusions or revocations on file
Checked against OIG LEIE on NPI 1679287395. Last verified May 11, 2026.Open Payments
Industry payments received
All-time total
$14
Transactions
1
Manufacturers
1
| Payer (manufacturer) | Industry | Txns | Amount |
|---|---|---|---|
| Merck Sharp & Dohme LLC | 1 | $14.44 |
By nature of payment
Hospital affiliations
Frequently asked questions
What is Dr. Ellice Clark's medical specialty?
Dr. Ellice Clark practices Certified Registered Nurse Anesthetist in Detroit, MI.
Where does Dr. Ellice Clark practice?
Dr. Ellice Clark practices at 4001 W McNichols RD, Detroit, MI 482213038. Office phone: 3139931245.
What is Dr. Ellice Clark's NPI?
Dr. Ellice Clark's National Provider Identifier (NPI) is 1679287395, issued by NPPES.
Does Dr. Ellice Clark accept Medicare assignment?
Dr. Ellice Clark does not accept Medicare assignment for all services. Patients may be billed amounts beyond Medicare-allowed charges.