Clark, Nicole Christine

Clark, Nicole Christine is an individual health care provider with primary practice located at 241 Lorraine Ave , Syracuse NY 13210-3229. She recently has only one registered license in Nursing Service Providers / Licensed Practical Nurse, which is considered as her primary health care specialty. Clark, Nicole Christine can be contacted via phone (315) 863-5885.

Contact Information

Primary practice address
241 Lorraine Ave Syracuse NY 13210-3229
Phone: (315) 863-5885
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Nursing Service Providers / Licensed Practical Nurse 164W00000X 251148-1 New York

Profile Details

NPI number 1982767604
LBN Legal business name Clark, Nicole Christine
Credentials Licensed Practical Nurse (LPN)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 18th, 2006
Last updated Jul 9th, 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1982767604 NPPES
New York MEDICAID 02120758

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