Doctor Name: | MS. NANCY L. CLARK |
NPI Number: | 1265595094 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | R.N. |
License Number: | 141878-1 |
Business Practice Address: | 302 Hinsdale Rd Camillus, NY - 130311636 |
Business Phone Number: | 3154879397 |
Business Fax Number: | |
Mailing Address: | 302 Hinsdale Rd, CAMILLUS |
State: | NY |
Postal Code: | 130311636 |
Phone Number: | 3154879397 |
Fax Number: | |
NPI Enumeration Date: | 12/19/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 163WH0200X |
License Number: | 141878-1 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NY |
Taxonomy Type: | Nursing Service Providers |
Taxonomy Classification: | Registered Nurse |
Taxonomy Specialization: | Home Health |
Taxonomy Definition: |