# SUSAN LEGENDER CLARKE

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** Yes

## Provider details

- **NPI number:** 1013905371
- **Gender:** F
- **Credential:** DC

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 111NN1001X | Nutrition Chiropractor | 2143 | MN | Yes |

## Other

- **Enumeration date:** 10/11/2005
- **Last updated:** 06/16/2010

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 041101001 | METROPOLITAN HEALTH PLAN | MN |
| 01 | — | 0N438CL | BCBS INDIVIDUAL PROVIDER | MN |
| 01 | — | 20705 | HEALTHPARTNERS ID | MN |
| 01 | — | 21316CL | BCBS CLINIC \# | MN |
| 01 | — | 350056171 | RRCARE | MN |
| 05 | — | 777027800 | — | MN |