Individual
CELESTE CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
5342 DUDLEY BLVD # 98, MCCLELLAN, CA 95652-1012
(916) 561-7520
Mailing address
5200 BRONDSBURY LN, FAIR OAKS, CA 95628-4087
(916) 561-7520
Taxonomy
Speciality
Code
Description
License number
State
163WC0400X
Case Management Registered Nurse
Primary
RN146571
AZ
Other
Enumeration date
08/13/2009
Last updated
08/13/2009
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