Ms Wanda Kaye Clark, FNP - Nurse Practitioner in Rock Hill, SC

Ms Wanda Kaye Clark, FNP is a Nurse Practitioner based in Rock Hill, South Carolina. Ms Wanda Kaye Clark is licensed to practice in South Carolina (license number 1484) and her current practice location is 1151 Camden Ave, Rock Hill, South Carolina. She can be reached at her office (for appointments etc.) via phone at (803) 909-6363.

NPI number for Ms Wanda Kaye Clark is 1043213457 and her current mailing address is 1151 Camden Ave, Rock Hill, South Carolina. She does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1043213457.

Contact Information

Ms Wanda Kaye Clark, FNP
1151 Camden Ave,
Rock Hill, SC 29732-3014
(803) 909-6363
(803) 909-6364

Map and Direction




Provider's Profile

Full NameMs Wanda Kaye Clark
GenderFemale
SpecialityNurse Practitioner
Location1151 Camden Ave, Rock Hill, South Carolina
Accepts Medicare AssignmentsDoes not participate in Medicare Program. She may not accept medicare assignment.
  NPI Data:
  • NPI Number: 1043213457
  • Provider Enumeration Date: 05/31/2005
  • Last Update Date: 07/09/2007

Medical Identifiers

Medical identifiers for Ms Wanda Kaye Clark such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1043213457NPI-NPPES
GP3059MedicaidSC

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
363L00000XNurse Practitioner 1484 (South Carolina)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 Wanda Kaye 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 AddressPractice Location Address
Ms Wanda Kaye Clark, FNP
1151 Camden Ave,
Rock Hill, SC 29732-3014

Ph: (803) 909-6363
Ms Wanda Kaye Clark, FNP
1151 Camden Ave,
Rock Hill, SC 29732-3014

Ph: (803) 909-6363

Reviews and Comments


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