Nicole Clark, RN is a
Registered Nurse based in Winter, Wisconsin. Nicole Clark is licensed to practice in Wisconsin (license number 233138) and her current practice location is
N4093 Keehn Rd, Winter, Wisconsin. She can be reached at her office (for appointments etc.) via phone at
(989) 709-1937.
NPI number for Nicole Clark is 1619486834 and her current mailing address is N4093 Keehn Rd, Winter, Wisconsin. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1619486834.
Provider's Profile
Full Name | Nicole Clark |
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Gender | Female |
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Speciality | Registered Nurse |
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Location | N4093 Keehn Rd, Winter, Wisconsin |
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Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
NPI Data:
- NPI Number: 1619486834
- Provider Enumeration Date: 09/20/2017
- Last Update Date: 03/17/2018
Medical Identifiers
Medical identifiers for Nicole Clark such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1619486834 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
163W00000X | Registered Nurse | 4704325266 (Michigan) | Secondary |
163W00000X | Registered Nurse | 233138 (Wisconsin) | 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. Nicole 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 |
Nicole Clark, RN N4093 Keehn Rd, Winter, WI 54896-7312 Ph: () - | Nicole Clark, RN N4093 Keehn Rd, Winter, WI 54896-7312 Ph: (989) 709-1937 |
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