Faith Clark

Individual provider Active NPI Licensed Practical Nurse · Hellertown, PA

NPI 1891164547 · NPPES record last updated Sep 23, 2015

Key facts

NPI
1891164547
Entity type
Individual (NPI type 1)
Primary specialty
Licensed Practical Nurse 164W00000X
License
PN263676 (PA)
Practice address
427 Main St
Hellertown, PA 18055-1721
Phone
(610) 814-7300
Fax
(484) 241-4490
NPI assigned
Sep 23, 2015
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

State licenses

LicenseStateTypeSpecialty
PN263676PAMDLicensed Practical Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X PN263676 PA Yes

Addresses

Primary practice location

427 Main St
Hellertown, PA 18055-1721

Mailing address

2178 Johnston Ave
Bethlehem, PA 18015-6213

Other providers in Hellertown, PA

All providers in Hellertown, PA · Licensed Practical Nurse in Pennsylvania

Sources for this page

Verify at the official NPI Registry.