MS. SUSAN MARIE CLARK C.R.N.P. NPI 1326055534

NPI Information

NPI: 1326055534
Provider Name: MS. SUSAN MARIE CLARK, C.R.N.P.
Classification: Nurse Practitioner - 363LF0000X
Entity Type: Individual

Specialization: Family

Address:
301 RANDOLPH ST
DENTON, MD
ZIP 21629
Phone: (410) 479-4306
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MS. Susan Marie Clark, C.R.N.P. is a family nurse practitioner in Denton, MD. MS. Susan Marie Clark, C.R.N.P. NPI is 1326055534. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

301 RANDOLPH ST
DENTON, MD
ZIP 21629-243
Phone: (410) 479-4306
Fax: (410) 479-1714

The enumeration date for this NPI number is 8/1/2006 and was last updated on 6/30/2008.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363LF0000X	Nurse Practitioner	Family	R157798	MARYLAND	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	521116591	OTHER	MARYLAND	TRICARE
2	521116591	OTHER	MARYLAND	MARYLAND PHYSICIANS CARE
3	Q77343	MEDICARE UPIN	MARYLAND
4	T5880040	OTHER	MARYLAND	CF BC/BS GRP/GHMSI/BL CHO
5	89583301	OTHER	MARYLAND	CAREFIRST BC/BS RENDERING
6	521116591	OTHER	MARYLAND	COVENTRY
7	521116591	OTHER	MARYLAND	INFORMED
8	766408	OTHER		NCPPO
9	9924498	OTHER		CIGNA
10	S135P756	MEDICARE PIN
11	207884	OTHER		PRIORITY PARTNERS
12	784381000	MEDICAID	MARYLAND

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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