# CARLITA CLARK

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

## Provider details

- **NPI number:** 1942784897
- **Gender:** F
- **Credential:** RN, CRNA

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207L00000X | Anesthesiology Physician | RN214385 | GA | — |
| 207LC0200X | Critical Care Medicine (Anesthesiology) Physician | RN214385 | GA | Yes |
| 367500000X | Certified Registered Nurse Anesthetist | 3017855 | KY | — |

## Other

- **Enumeration date:** 09/17/2018
- **Last updated:** 12/28/2022