Doctor Name: | MR. RICHARD D CLARK |
NPI Number: | 1659355121 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | RN ARNP CRNA |
License Number: | 1484659051 |
Business Practice Address: | 18221 Torrence Ave Lansing, IL - 604382870 |
Business Phone Number: | 7088959450 |
Business Fax Number: | |
Mailing Address: | 18221 Torrence Ave, LANSING |
State: | IL |
Postal Code: | 604382870 |
Phone Number: | 7088959408 |
Fax Number: | |
NPI Enumeration Date: | 11/30/2005 |
NPI Last Update Date: | 05/21/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 163W00000X |
License Number: | 1484659051 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | KS |
Taxonomy Type: | Nursing Service Providers |
Taxonomy Classification: | Registered Nurse |
Taxonomy Specialization: | |
Taxonomy Definition: | (1) A registered nurse is a person qualified by graduation from an accredited nursing school (depending upon schooling, a registered nurse may receive either a diploma from a hospital program, an associate degree in nursing (A.D.N.) or a Bachelor of Science degree in nursing (B.S.N.), who is licensed or certified by the state, and is practicing within the scope of that license or certification. R.N. |