Clara Clark, RN

Individual provider Active NPI Registered Nurse · Donalsonville, GA

NPI 1104589449 · NPPES record last updated Oct 13, 2021

Key facts

NPI
1104589449
Entity type
Individual (NPI type 1)
Primary specialty
Registered Nurse 163W00000X
License
RN199633 (GA)
Practice address
5906 Hwy 39
Donalsonville, GA 39845-6122
Phone
(800) 977-2186
Fax
(912) 387-4547
NPI assigned
Oct 13, 2021
Sex
Female
Sole proprietor
Yes

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
RN199633GAMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
National Home Care Corporation Current
since Oct 17, 2021
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN199633 GA Yes

Addresses

Primary practice location

5906 Hwy 39
Donalsonville, GA 39845-6122

Mailing address

5906 Hwy 39
Donalsonville, GA 39845-6122
Phone (800) 977-2186

Other providers in Donalsonville, GA

All providers in Donalsonville, GA · Registered Nurse in Georgia

Sources for this page

Verify at the official NPI Registry.