Clark, Brandi

Clark, Brandi is an individual health care provider with primary practice located at 3086 State Route 160 , Gallipolis OH 45631-8409. She recently has only one registered license in Nursing Service Providers / Licensed Practical Nurse, which is considered as her primary health care specialty. Clark, Brandi can be contacted via phone (740) 446-5500.

Contact Information

Primary practice address
3086 State Route 160 Gallipolis OH 45631-8409
Phone: (740) 446-5500
Fax: (740) 446-4951
Website:
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Health care specialties

SpecialtyCodeLicense #State
Nursing Service Providers / Licensed Practical Nurse 164W00000X PN.124270-M-IV Ohio

Profile Details

NPI number 1154780021
LBN Legal business name Clark, Brandi
Credentials Licensed Practical Nurse (LPN)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 19th, 2016
Last updated Feb 19th, 2016 - about 8 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1154780021 NPPES
Ohio MEDICAID 0200820

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