Callie Ann Clark
Individual provider Active NPI Case Manager/Care Coordinator · Devils Lake, ND
NPI 1104307149 · NPPES record last updated Aug 28, 2018
Key facts
- NPI
- 1104307149
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Case Manager/Care Coordinator 171M00000X
- Practice address
- 524 4TH Ave NE Unit 19
Devils Lake, ND 58301-2400 - Phone
- (701) 662-7050
- Fax
- (701) 662-3360
- NPI assigned
- Aug 28, 2018
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| County of Ramsey | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Case Manager/Care Coordinator | 171M00000X | ND | Yes |
Addresses
Primary practice location
524 4TH Ave NE Unit 19
Devils Lake, ND 58301-2400
Mailing address
524 4TH Ave NE Unit 19
Devils Lake, ND 58301-2400
Phone (701) 662-7050
Other providers in Devils Lake, ND
- Chiropractic Health Center PLLC
- Andriea Elizabeth Christie
- Christofferson Consulting
- Crystal Mae Christofferson
- Victoria Church
- Clinic Pharmacy Inc
- James R Clinkenbeard
- Terry A Clinkenbeard
- Megan Gean Clinton
- Sarah Ann Coenen
All providers in Devils Lake, ND · Case Manager/Care Coordinator in North Dakota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 28, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.