Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Natisha Irene Clark

Individual provider Registered Nurse · NPI 1871957985

Natisha Irene Clark is a Nurse Practitioner in West Bloomfield, Michigan. Qualified in 2016, 10 years ago. Practices with Henry Ford Health System, a 2,540-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Michigan.

Years since qualifying
10
Licensed in
MI
In the registry since
2016
Specialties on file
2
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Practice location Address checks out

6777 W Maple Rd
West Bloomfield, MI 48322-3013
Phone: (800) 683-6568
Fax: (313) 876-1305
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 15150 Fort St, Southgate, MI 48195-1302 — (734) 282-4800

Specialties & licences

Primary Care Nurse Practitioner (primary) Taxonomy 363LP2300X · Licence 4704278418 (MI)
Registered Nurse Taxonomy 163W00000X · Licence 4704278418 (MI)

Record details

NPI number1871957985
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedApril 6, 2016
Last updated in NPPESNovember 10, 2022
Certification dateNovember 10, 2022
Mailing address1 Ford Pl Ste 3a, Detroit, MI 48202-3450

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2016 (10 years in practice)
Group practice Henry Ford Health System — 2540 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in West Bloomfield