Carol Clark
Nurse Practitioner - Family Medicine Nurse Practitioner - Community Health
9015 E 17th St
Indianapolis
, Indiana 46229-2016
Carol Clark
Nurse Practitioner - Family Medicine Nurse Practitioner - Community Health
9015 E 17th St
Indianapolis
, Indiana 46229-2016
(317) 898-4219
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About
Features
Specialties
- Nurse Practitioner - Community Health
- Nurse Practitioner - Family Medicine
Languages spoken
- English
Location
First Address
- Carol Clark
- 9015 E 17th St
- Indianapolis, IN
- Zip : 46229-2016
- Fax : (317) 898-4219
- Phone : (317) 898-3166
Second Address
- Carol Clark
- 9015 E 17th St
- Indianapolis, IN
- Zip : 46229-2016
- Fax : (317) 898-4219
- Phone : (317) 898-3166
Reviews
FAQs
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Where did Carol Clark do her residency?
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What type of doctor is Carol Clark
In what state does Carol Clark practice in?
Where is Carol Clark ’s practice located?
What is Carol Clark ’s gender?
Is Carol Clark a sole practitioner?
Is Carol Clark accepting new patients?
What languages does Carol Clark speak?
Does Carol Clark accept insurance?
Does Carol Clark offers telemedicine?
What is Carol Clark ’s professional license number?
What is Carol Clark ’s NPI number?
Does Carol Clark have any license restrictions?
Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| N | 363LC1500X | Nurse Practitioner - Community Health | 71000959A | IN |
| Y | 363LF0000X | Nurse Practitioner - Family Medicine | 71000959A | IN |
National Provider Identifier
| NPI | 1770535502 |
|---|---|
| Provider Name | Carol Clark |
| First Address | Indianapolis, IN 46229-2016 |
| Second Address | Indianapolis, IN 46229-2016 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 17/05/2006 |
| Last Update Date | 02/05/2012 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 200307710 | (05) | IN |
| 232230QQQ | (02) | IN |
| P01016729 | RR MEDICARE PTAN (01) | IN |
| P54690 | (02) |
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.