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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

MRS. CLAUDETTE VIVIENNE CLARK, MSN,RN,CPNP,IBCLC

Active Sole Proprietor

MRS. CLAUDETTE VIVIENNE CLARK, MSN,RN,CPNP,IBCLC is a Primary Care Clinic healthcare provider located in FORT SAM HOUSTON, Texas. NPI 1053457135 is currently active in the NPPES registry. Verify at CMS.

Primary Care Clinic · FORT SAM HOUSTON, TX

Registration Details

NPI Number
1053457135
Provider Type
Individual
Gender
Female
NPI Issued
Jan 29, 2007 (19.563409705621 yrs)
Last Updated
Jul 8, 2007
License
1-059903 (AL)
Sole Proprietor
Yes

Practice Information

Address
3851 ROGER BROOKE DRIVE
BROOKE ARMY MEDICAL CENTER
FORT SAM HOUSTON, TX, 782346200
Browse TX providers · Browse ZIP 78234
Phone
2109169233
Primary Specialty
Primary Care Clinic
261QP2300X
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.