Individual
MS. VICKI E CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
460 COUNTRY CLUB RD, LUMBERTON, NC 28360-9494
(910) 671-3200
(910) 671-3484
Mailing address
460 COUNTRY CLUB RD, LUMBERTON, NC 28360-9494
(910) 671-3200
(910) 671-3484
Taxonomy
Speciality
Code
Description
License number
State
363LX0001X
Obstetrics & Gynecology Nurse Practitioner
Primary
940105
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1609878800
—
NC
Enumeration date
06/01/2005
Last updated
01/14/2025
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