Ann Marie Clack
Nurse Practitioner - Women's Health
4864 Jackson St
Monroe
, Louisiana 71202-6400
Ann Marie Clack
Nurse Practitioner - Women's Health
4864 Jackson St
Monroe
, Louisiana 71202-6400
(318) 626-0287
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About
Features
Specialties
- Nurse Practitioner - Women's Health
Languages spoken
- English
Location
First Address
- Ann Marie Clack
- 1512 W Kirby Pl
- Shreveport, LA
- Zip : 71103-3822
- Phone : (318) 626-0287
Second Address
- Ann Marie Clack
- 4864 Jackson St
- Monroe, LA
- Zip : 71202-6400
- Phone : (318) 330-7000
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 363LW0102X | Nurse Practitioner - Women's Health | 214452 | LA |
National Provider Identifier
| NPI | 1023689486 |
|---|---|
| Provider Name | Ann Marie Clack |
| First Address | Shreveport, LA 71103-3822 |
| Second Address | Monroe, LA 71202-6400 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 07/07/2021 |
| Last Update Date | 06/10/2021 |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.