Clark, Samuela

Clark, Samuela is an individual health care provider with primary practice located at 6306 N 7Th St , Phoenix AZ 85014-1549. She recently has only one registered license in Nursing Service Providers / Licensed Vocational Nurse, which is considered as her primary health care specialty. Clark, Samuela can be contacted via phone (602) 279-5801.

Contact Information

Primary practice address
6306 N 7Th St Phoenix AZ 85014-1549
Phone: (602) 279-5801
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Nursing Service Providers / Licensed Vocational Nurse 164X00000X VN192674 California

Profile Details

NPI number 1386837912
LBN Legal business name Clark, Samuela
Credentials Licensed Visiting Nurse (LVN)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 27th, 2007
Last updated Aug 27th, 2007 - about 18 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 1386837912 NPPES
Arizona Other 214634 AHCCCS
Arizona Other VN192674 AHCCCS

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