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

MS. NICOLLETTE SHAUTRIA CLARK

Active Sole Proprietor

MS. NICOLLETTE SHAUTRIA CLARK is a Podiatric Surgery healthcare provider located in MONTICELLO, Mississippi. NPI 1831746817 is currently active in the NPPES registry. Verify at CMS.

Podiatric Surgery · MONTICELLO, MS

Registration Details

NPI Number
1831746817
Provider Type
Individual
Gender
Female
NPI Issued
Aug 23, 2019 (6.952698061636 yrs)
Last Updated
Aug 23, 2019
Sole Proprietor
Yes

Practice Information

Address
940 NEAL PL
MONTICELLO, MS, 396547003
Browse MS providers · Browse ZIP 39654
Phone
6015229025
Primary Specialty
Podiatric Surgery
3747A0650X

Other Podiatric Surgery Providers in MONTICELLO, MS

Name Credential NPI
JAMIE NICOLE HARDISON 1760084909
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.