Clark, Krista M
Clark, Krista M is an sole proprietor health care provider with primary practice located at 810 Hadley Ave , Old Hickory TN 37138-3121. She recently has only one registered license in Other Service Providers / Prosthetics Case Management, which is considered as her primary health care specialty. Clark, Krista M can be contacted via phone (615) 847-8000.Contact Information
Primary practice address
810 Hadley Ave
Old Hickory TN 37138-3121
Phone: (615) 847-8000
Fax: (615) 847-4693
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Other Service Providers / Prosthetics Case Management | 1744P3200X |
Profile Details
| NPI number | 1073687224 |
|---|---|
| LBN Legal business name | Clark, Krista M |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Nov 20th, 2006 |
| Last updated | Dec 5th, 2007 - about 17 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 | 1073687224 | NPPES |
| Tennessee | Other | 4018836 | BCBS OF TN |
| Tennessee | MEDICAID | 1454254 | BCBS OF TN |
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