Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
THERESA CLARK
Active Sole ProprietorTHERESA CLARK is a Medical-Surgical Nurse healthcare provider located in PINEVILLE, Louisiana. NPI 1104079839 is currently active in the NPPES registry. Verify at CMS.
Medical-Surgical Nurse · PINEVILLE, LA
Registration Details
- NPI Number
- 1104079839
- Provider Type
- Individual
- Gender
- Female
- NPI Issued
- Oct 26, 2008 (17.654933697084 yrs)
- Last Updated
- Oct 26, 2008
- License
-
163WM0705X (LA)
- Sole Proprietor
- Yes
Practice Information
- Address
-
2495 SHREVEPORT HWYPINEVILLE, LA, 713604044Browse LA providers · Browse ZIP 71360
- Phone
- 3184730010
- Primary Specialty
-
Medical-Surgical Nurse
163WM0705X
Other Medical-Surgical Nurse Providers in PINEVILLE, LA
| Name | Credential | NPI |
|---|---|---|
| JERELYN CARPENTER | — | 1609390327 |
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.