Individual
PATRICIA CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
1316 HYMELIA AVE, METAIRIE, LA 70003-3710
(504) 818-2296
Mailing address
1316 HYMELIA AVE, METAIRIE, LA 70003-3710
(504) 818-2296
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
AP04330
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1173762
—
LA
Enumeration date
10/19/2006
Last updated
05/15/2008
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