Individual
SHAWN CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
REGISTERED NURSE
Contact information
Practice address
405 TAYLOR RD, FALL BRANCH, TN 37656-3013
(423) 726-1139
Mailing address
405 TAYLOR RD, FALL BRANCH, TN 37656-3013
(423) 726-1139
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN0000147665
TN
Other
Enumeration date
03/12/2016
Last updated
03/12/2016
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