Ms Connie Ruth Clark, ARNP is a
Nurse Practitioner based in Stevenson, Washington. Ms Connie Ruth Clark is licensed to practice in Washington (license number AP60258145) and her current practice location is
710 Sw Rock Creek Dr, Stevenson, Washington. She can be reached at her office (for appointments etc.) via phone at
(509) 427-3850.
NPI number for Ms Connie Ruth Clark is 1336303106 and her current mailing address is Po Box 1492, Stevenson, Washington. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1336303106.
Provider's Profile
| Full Name | Ms Connie Ruth Clark |
|---|
| Gender | Female |
|---|
| Speciality | Nurse Practitioner |
|---|
| Location | 710 Sw Rock Creek Dr, Stevenson, Washington |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1336303106
- Provider Enumeration Date: 07/10/2008
- Last Update Date: 03/19/2019
Medical Identifiers
Medical identifiers for Ms Connie Ruth Clark such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1336303106 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 363L00000X | Nurse Practitioner | AP60258145 (Washington) | 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. Ms Connie Ruth 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 |
|---|
Ms Connie Ruth Clark, ARNP
Po Box 1492,
Stevenson, WA 98648-1492
Ph: (509) 427-3850 | Ms Connie Ruth Clark, ARNP
710 Sw Rock Creek Dr,
Stevenson, WA 98648-4418
Ph: (509) 427-3850 |
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