Clark, Rebecca S.

Clark, Rebecca S. is an individual health care provider with primary practice located at 10600 Industrial Dr , Minden LA 71055-5105. 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, Rebecca S. can be contacted via phone (318) 798-4616.

Contact Information

Primary practice address
10600 Industrial Dr Minden LA 71055-5105
Phone: (318) 798-4616
Fax: (318) 798-4619
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X AP05233 Louisiana

Profile Details

NPI number 1891987343
LBN Legal business name Clark, Rebecca S.
Credentials Family Nurse Practitioner (FNP)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 17th, 2007
Last updated Apr 10th, 2017 - about 7 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 1891987343 NPPES
Louisiana MEDICAID 1362484

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