Susan Legender Clarke
Nutrition
846 Laurel Ave
Saint Paul
, Minnesota 55104-7110
(651) 227-1055
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About
Features
Language(s) Spoken
English
Ethnic Identity
White / Caucasian
Specialties
- Nutrition
Languages spoken
- English
Location
First Address
- Susan Legender Clarke
- 846 Laurel Ave
- Saint Paul, MN
- Zip : 55104-7110
- Fax : (651) 227-1055
- Phone : (651) 227-8776
Second Address
- Susan Legender Clarke
- 846 Laurel Ave
- Saint Paul, MN
- Zip : 55104-7110
- Fax : (651) 227-1055
- Phone : (651) 227-8776
Reviews
FAQs
Where did Susan Legender Clarke attend graduate school?
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Where did Susan Legender Clarke do her residency?
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Where did Susan Legender Clarke do her fellowship?
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Is Susan Legender Clarke board certified?
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What type of doctor is Susan Legender Clarke
Nutrition
In what state does Susan Legender Clarke practice in?
Minnesota
Where is Susan Legender Clarke ’s practice located?
846 Laurel Ave , Saint Paul, Minnesota, 55104-7110
What is Susan Legender Clarke ’s gender?
Female
Is Susan Legender Clarke a sole practitioner?
No
Is Susan Legender Clarke accepting new patients?
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What languages does Susan Legender Clarke speak?
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Does Susan Legender Clarke accept insurance?
Yes, Susan Legender Clarke accepts insurance
Does Susan Legender Clarke offers telemedicine?
Susan Legender Clarke has not indicated if she offers telemedicine
What is Susan Legender Clarke ’s professional license number?
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What is Susan Legender Clarke ’s NPI number?
1013905371
Does Susan Legender Clarke have any license restrictions?
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 111NN1001X | Nutrition | 2143 | MN |
National Provider Identifier
| NPI | 1013905371 |
|---|---|
| Provider Name | Susan Legender Clarke |
| First Address | Saint Paul, MN 55104-7110 |
| Second Address | Saint Paul, MN 55104-7110 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | Yes |
| Is Organization Subpart | N/A |
| Enumeration Date | 11/10/2005 |
| Last Update Date | 16/06/2010 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 041101001 | METROPOLITAN HEALTH PLAN (01) | MN |
| 0N438CL | BCBS INDIVIDUAL PROVIDER (01) | MN |
| 20705 | HEALTHPARTNERS ID (01) | MN |
| 21316CL | BCBS CLINIC # (01) | MN |
| 350056171 | RRCARE (01) | MN |
| 777027800 | (05) | MN |
| T39821 | (02) | MN |
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)
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.
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.