Individual
MRS. ANISSA BRANT CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
929 ESTATES RD SE, ROANOKE, VA 24014-4307
(540) 676-4806
Mailing address
929 ESTATES RD SE, ROANOKE, VA 24014-4307
(540) 676-4806
Taxonomy
Speciality
Code
Description
License number
State
163WC0400X
Case Management Registered Nurse
Primary
0001226621
VA
Other
Enumeration date
03/04/2022
Last updated
03/04/2022
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