Celeste Clark, RN

Individual provider Active NPI Case Management Registered Nurse · McClellan, CA

NPI 1285866939 · NPPES record last updated Aug 13, 2009

Key facts

NPI
1285866939
Entity type
Individual (NPI type 1)
Primary specialty
Case Management Registered Nurse 163WC0400X
License
RN146571 (AZ)
Practice address
5342 Dudley Blvd # 98
McClellan, CA 95652-1012
Phone
(916) 561-7520
NPI assigned
Aug 13, 2009
Sex
Female
Sole proprietor
No

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
RN146571AZMDCase Management Registered Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Case Management Registered Nurse 163WC0400X RN146571 AZ Yes

Addresses

Primary practice location

5342 Dudley Blvd # 98
McClellan, CA 95652-1012

Mailing address

5200 Brondsbury LN
Fair Oaks, CA 95628-4087
Phone (916) 561-7520

Other providers in McClellan, CA

All providers in McClellan, CA · Case Management Registered Nurse in California

Sources for this page

Verify at the official NPI Registry.