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

SHANNA G CLARK, LPN

Deactivated

SHANNA G CLARK, LPN is a Licensed Practical Nurse healthcare provider located in FORT EDWARD, New York. NPI 1831442698 is deactivated in the NPPES registry. Verify at CMS.

Licensed Practical Nurse · FORT EDWARD, NY

This NPI has been deactivated. The record was deactivated on October 21, 2020. Deactivated NPIs are no longer valid for billing or credentialing. The provider may have retired, changed practice status, or had their NPI administratively deactivated. Verify current licensure status with the NPPES NPI Registry or the relevant state medical board before relying on this record.

Registration Details

NPI Number
1831442698
Provider Type
Individual
Gender
Female
NPI Issued
Oct 18, 2012 (8.0082191780822 yrs)
Last Updated
Oct 28, 2020
Deactivated
Oct 21, 2020
License
277227 (NY)

Practice Information

Address
130 WHITE BIRCH EST
FORT EDWARD, NY, 128289275
Browse NY providers · Browse ZIP 12828
Phone
5184158643
Primary Specialty
Licensed Practical Nurse
164W00000X

Other Licensed Practical Nurse Providers in FORT EDWARD, NY

Name Credential NPI
SUEANNE SHEPPARD-NIEDHAMMER LPN 1508925959
STEPHEN LAPE LPN 1235365065
MARINEA BONENFANT 1770816589
MRS. BONNIE SUMMERS OVITT LPN 1043548118
MRS. ASHLEY DIANE JOHNSON LPN 1689935215
MRS. LESLIE CARPENTER LPN 1740640416
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.