Clark, Radonna
Clark, Radonna is an individual health care provider with primary practice located at 25 Kessel Ct Ste 102 , Madison WI 53711-6227. She recently has only one registered license in Other Service Providers / Case Manager/Care Coordinator, which is considered as her primary health care specialty. Clark, Radonna can be contacted via phone (608) 280-2700.Contact Information
Primary practice address
25 Kessel Ct Ste 102
Madison WI 53711-6227
Phone: (608) 280-2700
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Other Service Providers / Case Manager/Care Coordinator | 171M00000X | Wisconsin |
Profile Details
| NPI number | 1255050761 |
|---|---|
| LBN Legal business name | Clark, Radonna |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 26th, 2022 |
| Last updated | Aug 26th, 2022 - about 4 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1255050761 | NPPES |
| Texas | Other | 499004280 | SSNS |
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