Individual
MRS. DONNA MARIE CLARK-RIDDLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
612 MOCKSVILLE AVE, SALISBURY, NC 28144-2732
(704) 210-5661
Mailing address
1635 WATERFORD POINTE RD, LEXINGTON, NC 27292-6566
(336) 798-0610
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
48591
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
430059241
RR MEDICARE
NC
05
—
8051337
—
NC
Enumeration date
07/07/2006
Last updated
10/27/2020
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