Individual
MRS. REBECCA THERESA CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
3236 KIRKMAN ST, LAKE CHARLES, LA 70601-8640
(337) 478-6020
(337) 475-4820
Mailing address
1120 LASALETTE AVE, SULPHUR, LA 70663-5124
(337) 304-7985
Taxonomy
Speciality
Code
Description
License number
State
163WC1500X
Community Health Registered Nurse
Primary
RN088489
LA
Other
Enumeration date
06/13/2014
Last updated
06/13/2014
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