Individual
RONALD BRANDON CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
FNP
Contact information
Practice address
971 ROBERT BLVD, SLIDELL, LA 70458-2009
(985) 690-8300
Mailing address
162 TCHEFUNCTE PARC DR, MADISONVILLE, LA 70447-9759
(985) 351-3553
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
AP07081
LA
363L00000X
Nurse Practitioner
R851752
MS
Other
Enumeration date
01/19/2012
Last updated
07/09/2025
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