Clark-Kutscher, B. Carol

Clark-Kutscher, B. Carol is an individual health care provider with primary practice located at 409 W Oak St , Carbondale IL 62901-1414. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Adult Health, Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner. Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner is her primary health care specialty. Clark-Kutscher, B. Carol can be contacted via phone (618) 529-4455.

Contact Information

Primary practice address
409 W Oak St Carbondale IL 62901-1414
Phone: (618) 529-4455
Fax: (618) 351-1287
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Adult Health 363LA2200X 114921 Missouri
Physician Assistants & Advanced Practice Nursing Providers / Adult Health 363LA2200X 209007469 Illinois
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X 209007469 Illinois

Profile Details

NPI number 1962507087
LBN Legal business name Clark-Kutscher, B. Carol
Credentials Adult Nurse Practitioner (ANP)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 13th, 2006
Last updated Jan 26th, 2023 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1962507087 NPPES
Missouri MEDICAID 428317200

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