Clark, Charlene
Clark, Charlene is an individual health care provider with primary practice located at 840 E Hill Ave , Moses Lake WA 98837-2238. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Clark, Charlene can be contacted via phone (509) 663-8711.Contact Information
Primary practice address
840 E Hill Ave
Moses Lake WA 98837-2238
Phone: (509) 663-8711
Fax: (731) 658-4079
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Family | 363LF0000X | 19070 | Tennessee |
| Physician Assistants & Advanced Practice Nursing Providers / Family | 363LF0000X | AP61098520 | Washington |
Profile Details
| NPI number | 1144621756 |
|---|---|
| LBN Legal business name | Clark, Charlene |
| Credentials | Family Nurse Practitioner (FNP) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Sep 15th, 2014 |
| Last updated | Sep 24th, 2020 - about 4 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1144621756 | NPPES |
| Tennessee | Other | 19070 | APN LICENSE |
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