MRS. DEBRA ANN CLARK RN NPI 1508079328

NPI Information

  • NPI: 1508079328
  • Provider Name: MRS. DEBRA ANN CLARK, RN
  • Classification: Registered Nurse - 163WP0200X
  • Specialization: Pediatrics
  • Entity Type: Individual
  • Address: 2044 MADISON AVE
    SUITE G7
    GRANITE CITY, IL
    ZIP 62040
  • Phone: (618) 451-6685

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NPI Details

MRS. Debra Ann Clark, RN is a pediatrics registered nurse in Granite City, IL. MRS. Debra Ann Clark, RN NPI is 1508079328. 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:

2044 MADISON AVE
SUITE G7
GRANITE CITY, IL
ZIP 62040-641
Phone: (618) 451-6685
Fax: (618) 451-7292

The enumeration date for this NPI number is 5/8/2007 and was last updated on 7/8/2007.

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
1163WP0200XRegistered NursePediatricsILLINOISYes

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: 11/21/2025

NPI Synchronization or Removal

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