Clark, Louann

Clark, Louann is an individual health care provider with primary practice located at 14027 5Th St , Dade City FL 33525-4302. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, which is considered as her primary health care specialty. Clark, Louann can be contacted via phone (352) 518-2000.

Contact Information

Primary practice address
14027 5Th St Dade City FL 33525-4302
Phone: (352) 518-2000
Fax: (352) 567-0218
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X ARNP3198092 Florida

Profile Details

NPI number 1710940333
LBN Legal business name Clark, Louann
Credentials ARNP
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 7th, 2006
Last updated Oct 21st, 2011 - about 15 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 1710940333 NPPES
Florida MEDICAID 3021360000

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