Mrs Antoinette Kelly-clark, is a
Case Manager/care Coordinator based in Ruston, Louisiana. Mrs Antoinette Kelly-clark is licensed to practice in * (Not Available) (license number ) and her current practice location is
171 Water Tank Rd, Ruston, Louisiana. She can be reached at her office (for appointments etc.) via phone at
(318) 548-7242.
NPI number for Mrs Antoinette Kelly-clark is 1417638800 and her current mailing address is 171 Water Tank Rd, Ruston, Louisiana. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1417638800.
Healthcare Provider's Profile
Full Name | Mrs Antoinette Kelly-clark |
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Gender | Female |
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Speciality | Case Manager/care Coordinator |
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Location | 171 Water Tank Rd, Ruston, Louisiana |
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Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
NPI Data:
- NPI Number: 1417638800
- Provider Enumeration Date: 07/27/2023
- Last Update Date: 08/22/2024
Medical Identifiers
Medical identifiers for Mrs Antoinette Kelly-clark such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1417638800 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
103TC1900X | Psychologist - Counseling | (* (Not Available)) | Secondary |
171M00000X | Case Manager/care Coordinator | (* (Not Available)) | 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. Mrs Antoinette Kelly-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 |
Mrs Antoinette Kelly-clark, 171 Water Tank Rd, Ruston, LA 71270-8550 Ph: (318) 548-7242 | Mrs Antoinette Kelly-clark, 171 Water Tank Rd, Ruston, LA 71270-8550 Ph: (318) 548-7242 |
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