Individual provider · Type 1 NPI

Theresa Clark

Medical-Surgical Registered Nurse · Pineville, LA

NPI number 1104079839 Active

Practice location

2495 Shreveport Hwy
Pineville, LA 71360-4044

Mailing address

107 Boundary Dr
Woodworth, LA 71485-9719

Specialties and licenses

TaxonomyCodeLicense
Medical-Surgical Registered Nurse Primary 163WM0705X163WM0705X (LA)

Medical-Surgical Registered Nurse: Definition to come...

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About NPI 1104079839

Theresa Clark's National Provider Identifier is 1104079839, issued on Oct 26, 2008. The primary taxonomy on file is Medical-Surgical Registered Nurse (163WM0705X), and the practice location is in Pineville, LA. The record was last updated on Oct 26, 2008.