Clark, Kathleen Mary
Clark, Kathleen Mary is an individual health care provider with primary practice located at 2800 Ashland Rd , Columbia SC 29210-5010. She recently has only one registered license in Nursing Service Providers / School, which is considered as her primary health care specialty. Clark, Kathleen Mary can be contacted via phone (803) 476-8509.Contact Information
Primary practice address
2800 Ashland Rd
Columbia SC 29210-5010
Phone: (803) 476-8509
Fax: (803) 476-8520
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Nursing Service Providers / School | 163WS0200X | 42521 | South Carolina |
Profile Details
| NPI number | 1407290364 |
|---|---|
| LBN Legal business name | Clark, Kathleen Mary |
| Credentials | Registered Nurse (RN) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Apr 23rd, 2013 |
| Last updated | Apr 23rd, 2013 - about 11 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 | 1407290364 | NPPES |
| South Carolina | MEDICAID | 42521 |
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