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Nicole Clark

Prosthetist

100 N Burke Ave
Long Beach , Mississippi 39560-4605

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Nicole Clark

Prosthetist

100 N Burke Ave
Long Beach , Mississippi 39560-4605

(228) 234-1658

Write a Review Save Call

Nicole Clark

Prosthetist

100 N Burke Ave
Long Beach , Mississippi 39560-4605

(228) 234-1658 Call

Write a Review Save

About


Features

Language(s) Spoken
English
Ethnic Identity
White / Caucasian

Specialties

  • Prosthetist

Languages spoken

  • English

Location

100 N Burke Ave Long Beach , Mississippi 39560-4605

First Address

  • Nicole Clark
  • 100 N Burke Ave
  • Long Beach, MS
  • Zip : 39560-4605
  • Phone : (228) 234-1658

Second Address

  • Nicole Clark
  • 100 N Burke Ave
  • Long Beach, MS
  • Zip : 39560-4605
  • Phone : (228) 234-1658

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FAQs


Where did Nicole Clark attend graduate school?

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Where did Nicole Clark do her residency?

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Where did Nicole Clark do her fellowship?

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Is Nicole Clark board certified?

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What type of doctor is Nicole Clark

Prosthetist

In what state does Nicole Clark practice in?

Mississippi

Where is Nicole Clark ’s practice located?

100 N Burke Ave , Long Beach, Mississippi, 39560-4605

What is Nicole Clark ’s gender?

Female

Is Nicole Clark a sole practitioner?

No

Is Nicole Clark accepting new patients?

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What languages does Nicole Clark speak?

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Does Nicole Clark accept insurance?

Yes, Nicole Clark accepts insurance

Does Nicole Clark offers telemedicine?

Nicole Clark has not indicated if she offers telemedicine

What is Nicole Clark ’s professional license number?

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What is Nicole Clark ’s NPI number?

1386106375

Does Nicole Clark have any license restrictions?

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Scope of Practice

Primary Taxonomy Code Taxonomy Specialty License Number License State
Y 224P00000X Prosthetist

National Provider Identifier

NPI 1386106375
Provider Name Nicole Clark
First Address Long Beach, MS 39560-4605
Second Address Long Beach, MS 39560-4605
Gender F
NPI Entity type Individual
Is Sole Proprietor Yes
Is Organization Subpart N/A
Enumeration Date 01/04/2019
Last Update Date 01/04/2019

NPI Footnotes


What is the National Provider Identifier (NPI)

The NPI is 10-position all-numeric identification number assigned by the NPPES to uniquely identify a health care provider.

Provider Location Address

The location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.

Provider Mailing Address

The mailing address of the provider being identified. This address may contain the same information as the provider location address.

Entity Type Code

The code describing the type of health care provider that is being assigned an NPI. The entity type codes are:
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?

Subparts are the components and separate physical locations of organization health care providers. Subpart examples include: Hospital components include outpatient departments, surgical centers, psychiatric units, and laboratories. These components are often separately licensed or certified by States and may exist at physical locations other than that of the hospital of which they are a component.

Provider Other Organization Name

The other organization name is the alternative last name by which the provider is or has been known (if an individual) or other name by which the organization provider is or has been known. The code identifying the type of other name. The provider other organization name codes are:
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.

Provider Enumeration Date

The date the provider was assigned a unique identifier (assigned an NPI)

Last Update Date

The date that a NPI record was last updated or changed

Primary Taxonomy Code

The primary taxonomy code defines the provider type, classification, and specialization. There could be only one primary taxonomy code per NPI record. For individual NPls the license data is associated to the taxonomy code.

Authorized Official Name

The name of the person authorized to submit the PI application or to officially change data for a health care provider.

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