Individual provider · Type 1 NPI
Lionel Herbert Clack
Registered Nurse · Covina, CA
Practice location
1161 E Covina Blvd
Covina, CA 91724-1523
Fax (626) 608-2645
Mailing address
14094 Maricopa Rd
Victorville, CA 92392-9777
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Registered Nurse Primary | 163W00000X | 724717 (CA) |
Registered Nurse: (1) A registered nurse is a person qualified by graduation from an accredited nursing school (depending upon schooling, a registered nurse may receive either a diploma from a hospital program, an associate degree in nursing (A.D.N.) or a Bachelor of Science degree in nursing (B.S.N.), who is licensed or certified by the state, and is practicing within the scope of that license or certification. R.N.'s assist patient…
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About NPI 1366089377
Lionel Herbert Clack's National Provider Identifier is 1366089377, issued on Dec 9, 2019. The primary taxonomy on file is Registered Nurse (163W00000X), and the practice location is in Covina, CA. The record was last updated on Dec 9, 2019.