KRISTA M CLARK NPI 1073687224

NPI Information

NPI: 1073687224
Provider Name: KRISTA M CLARK
Classification: Specialist - 1744P3200X
Entity Type: Individual

Specialization: Prosthetics Case Management

Address:
810 HADLEY AVE
OLD HICKORY, TN
ZIP 37138
Phone: (615) 847-8000
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Krista M Clark is a prosthetics case management specialist in Old Hickory, TN. Krista M Clark NPI is 1073687224. 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:

810 HADLEY AVE
OLD HICKORY, TN
ZIP 37138-121
Phone: (615) 847-8000
Fax: (615) 847-4693

The enumeration date for this NPI number is 11/20/2006 and was last updated on 12/5/2007.

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	1744P3200X	Specialist	Prosthetics Case Management			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	1454254	MEDICAID	TENNESSEE
2	4018836	OTHER	TENNESSEE	BCBS OF TN
3	1307810001	MEDICARE NSC	TENNESSEE

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: 4/28/2024

NPI Synchronization or Removal

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