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Individual

MRS. KOLU S. BAYSAH CLARK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DNP

Contact information

Practice address
455 TOLL GATE RD, WARWICK, RI 02886-2759
(401) 737-7010
Mailing address
455 TOLLGATE RD, PROFESSIONAL REVENUE CYCLE AND CREDENTIALING, WARWICK, RI 02886-2759
(401) 273-0641
(401) 273-2919

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
APRN00086
RI
363L00000X
Nurse Practitioner
RN2269378
MA
363LG0600X
Gerontology Nurse Practitioner
Primary
APRN00086
RI
363LP2300X
Primary Care Nurse Practitioner
APRN00086
RI
363LP2300X
Primary Care Nurse Practitioner
RN2269378
MA

Other

Enumeration date
04/13/2015
Last updated
04/15/2026
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