Latisa Clark, LPN is a
Licensed Practical Nurse based in Milford, Delaware. Latisa Clark is licensed to practice in Delaware (license number L2-0012231) and her current practice location is
769 E Masten Cir Ste 113, Milford, Delaware. She can be reached at her office (for appointments etc.) via phone at
(302) 856-4700.
NPI number for Latisa Clark is 1295225431 and her current mailing address is 769 E Masten Cir Ste 113, Milford, Delaware. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1295225431.
Provider's Profile
Full Name | Latisa Clark |
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Gender | Female |
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Speciality | Licensed Practical Nurse |
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Location | 769 E Masten Cir Ste 113, Milford, Delaware |
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Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
NPI Data:
- NPI Number: 1295225431
- Provider Enumeration Date: 05/14/2018
- Last Update Date: 05/14/2018
Medical Identifiers
Medical identifiers for Latisa Clark such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1295225431 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
164W00000X | Licensed Practical Nurse | L2-0012231 (Delaware) | 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. Latisa 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 |
Latisa Clark, LPN 769 E Masten Cir Ste 113, Milford, DE 19963-1268 Ph: (302) 856-4700 | Latisa Clark, LPN 769 E Masten Cir Ste 113, Milford, DE 19963-1268 Ph: (302) 856-4700 |
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