Individual provider · Type 1 NPI
Michael Anthony Clark, R.N.
General Practice Registered Nurse · Mather, CA
NPI number
1255478111
Active
Practice location
10535 Hospital Way
Mather, CA 95655-4200
Mailing address
1780 Creekside Dr, Apt: 2424
Folsom, CA 95630-3838
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Case Management Registered Nurse | 163WC0400X | RN 199634 (OH) |
| Emergency Registered Nurse | 163WE0003X | 741297 (CA) |
| Critical Care Medicine Registered Nurse | 163WC0200X | 741297 (CA) |
| General Practice Registered Nurse Primary | 163WG0000X | 741297 (CA) |
General Practice Registered Nurse: Definition to come...
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About NPI 1255478111
Michael Anthony Clark, R.N.'s National Provider Identifier is 1255478111, issued on Jan 31, 2007. The primary taxonomy on file is General Practice Registered Nurse (163WG0000X), and the practice location is in Mather, CA. The record was last updated on Jun 29, 2012.