Clarkson, Jerry

Clarkson, Jerry is an sole proprietor health care provider with primary practice located at 200 Commodore St , Pratt KS 67124-2903. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered, which is considered as his primary health care specialty. Clarkson, Jerry can be contacted via phone (620) 672-7451.

Contact Information

Primary practice address
200 Commodore St Pratt KS 67124-2903
Phone: (620) 672-7451
Fax: (316) 652-0340
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X 54408 Kansas

Profile Details

NPI number 1558339010
LBN Legal business name Clarkson, Jerry
Credentials Certified Registered Nurse Anesthetist (CRNA)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Mar 10th, 2006
Last updated Oct 4th, 2011 - about 14 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 1558339010 NPPES
Kansas MEDICAID 100143840C
Kansas Other 012137
Kansas MEDICAID 200029270A
Kansas Other 430001730

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