Individual provider · Type 1 NPI

Crystal Clark

Licensed Practical Nurse · Winston Salem, NC

NPI number 1194391185 Active

Practice location

650 Highland Ave # 100
Winston Salem, NC 27101-4304

Mailing address

284 Executive Park Dr Ste 100
Concord, NC 28025-1833

Specialties and licenses

TaxonomyCodeLicense
Licensed Practical Nurse Primary 164W00000X091485 (NC)

Licensed Practical Nurse: An individual with post-high school vocational training and practical experience in the provision of nursing care at a level less than that required for certification as a Registered Nurse. Requirements for education, experience, licensure, and job responsibilities vary among the states.

2 other providers at this address

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About NPI 1194391185

Crystal Clark's National Provider Identifier is 1194391185, issued on Jun 1, 2021. The primary taxonomy on file is Licensed Practical Nurse (164W00000X), and the practice location is in Winston Salem, NC. The record was last updated on Jun 1, 2021.