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Individual
CARLITA CLARK
Active
Individual
CARLITA CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN, CRNA
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
RN214385
GA
207LC0200X
Critical Care Medicine (Anesthesiology) Physician
Primary
RN214385
GA
367500000X
Certified Registered Nurse Anesthetist
3017855
KY
Other
Enumeration date
09/17/2018
Last updated
12/28/2022
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