Individual
MRS. MIKAILA ANN TURNER CLARKE
Active
Individual
MRS. MIKAILA ANN TURNER CLARKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
5553
MA
163W00000X
Registered Nurse
RN2275336
MA
363LA2200X
Adult Health Nurse Practitioner
Primary
RN2275336
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1301071
GROUP MEDICAID NUMBER
MA
05
—
1302604
—
MA
Enumeration date
01/25/2007
Last updated
05/17/2023
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