Individual
CHANDRA H. CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN, CDCES
Contact information
Practice address
11106 HAWKES LANE, BLACKSTONE, VA 23824
(757) 327-1817
Mailing address
11106 HAWKES LANE, BLACKSTONE, VA 23824
(757) 327-1817
Taxonomy
Speciality
Code
Description
License number
State
163WD0400X
Diabetes Educator Registered Nurse
Primary
0001157171
VA
Other
Enumeration date
01/08/2021
Last updated
01/08/2021
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