Individual provider · Type 1 NPI

Keidra Clark, MSN, RN

Registered Nurse · Lake Charles, LA

NPI number 1700711215 Active

Practice location

2615 Enterprise Blvd Ste B
Lake Charles, LA 70601-7686

Call (337) 802-1757 Map

Mailing address

5408 Waterside Dr
Lake Charles, LA 70607-1004

Specialties and licenses

Taxonomy	Code	License
Registered Nurse Primary	163W00000X	RN129991 (LA)

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 1700711215

Keidra Clark, MSN, RN's National Provider Identifier is 1700711215, issued on Jun 16, 2026. The primary taxonomy on file is Registered Nurse (163W00000X), and the practice location is in Lake Charles, LA. The record was last updated on Jun 16, 2026.