NPI 1104079839
Theresa Clark
Practice location
- Address
- 2495 Shreveport Hwy, Pineville, LA 71360-4044
- Phone
- (318) 473-0010
- Mailing address
- 107 Boundary Dr, Woodworth, LA 71485-9719
Registered specialties
Medical-Surgical Registered Nurse
Primary
Registry record
- NPI
- 1104079839
- Entity type
- Individual
- Sex (as registered)
- Female
- NPI issued
- 26 Oct 2008
- Record last updated
- 26 Oct 2008
Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.