Kelly Patricia Clark, LPN is a
Licensed Practical Nurse based in Mason, Michigan. Kelly Patricia Clark is licensed to practice in Michigan (license number 4703110786) and her current practice location is
55 Pine Dr E, Mason, Michigan. She can be reached at her office (for appointments etc.) via phone at
(517) 394-6484.
NPI number for Kelly Patricia Clark is 1013474410 and her current mailing address is 55 Pine Dr E, Mason, Michigan. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1013474410.
Provider's Profile
Full Name | Kelly Patricia Clark |
---|
Gender | Female |
---|
Speciality | Licensed Practical Nurse |
---|
Location | 55 Pine Dr E, Mason, Michigan |
---|
Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
NPI Data:
- NPI Number: 1013474410
- Provider Enumeration Date: 02/22/2019
- Last Update Date: 02/22/2019
Medical Identifiers
Medical identifiers for Kelly Patricia Clark such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1013474410 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
164W00000X | Licensed Practical Nurse | 4703110786 (Michigan) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Kelly Patricia Clark is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Kelly Patricia Clark, LPN 55 Pine Dr E, Mason, MI 48854-9229 Ph: (517) 394-6484 | Kelly Patricia Clark, LPN 55 Pine Dr E, Mason, MI 48854-9229 Ph: (517) 394-6484 |
Reviews and Comments