Individual
MRS. ANTOINETTE NADINE CLARKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
22 MANITOU AVE, POUGHKEEPSIE, NY 12603-2736
(845) 891-5889
Mailing address
22 MANITOU AVE, POUGHKEEPSIE, NY 12603-2736
(845) 891-5889
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
7055753UPD
NY
Other
Enumeration date
04/12/2011
Last updated
01/05/2012
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