Clark, Shana

Clark, Shana is an sole proprietor health care provider with primary practice located at 25900 Greenfield Rd Ste 414 , Oak Park MI 48237-1267. She recently has only one registered license in Nursing Service Providers / Registered Nurse, which is considered as her primary health care specialty. Clark, Shana can be contacted via phone (248) 242-1193.

Contact Information

Primary practice address
25900 Greenfield Rd Ste 414 Oak Park MI 48237-1267
Phone: (248) 242-1193
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Nursing Service Providers / Registered Nurse 163W00000X 4704307625 Michigan

Profile Details

NPI number 1861004319
LBN Legal business name Clark, Shana
Credentials Registered Nurse (RN)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Aug 17th, 2020
Last updated Aug 17th, 2020 - about 4 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 1861004319 NPPES
Michigan MEDICAID 8848947

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