CAROL CLARK CNP NPI 1770535502

NPI Information

NPI: 1770535502
Provider Name: CAROL CLARK, CNP
Classification: Nurse Practitioner - 363LF0000X
Entity Type: Individual

Specialization: Family

Address:
9015 E 17TH ST
INDIANAPOLIS, IN
ZIP 46229
Phone: (317) 898-3166
Get Directions

Carol Clark, CNP is a family nurse practitioner in Indianapolis, IN. Carol Clark, CNP NPI is 1770535502. 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:

9015 E 17TH ST
INDIANAPOLIS, IN
ZIP 46229-016
Phone: (317) 898-3166
Fax: (317) 898-4219

The enumeration date for this NPI number is 5/17/2006 and was last updated on 5/2/2012.

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	363LC1500X	Nurse Practitioner	Community Health	71000959A	INDIANA	No
2	363LF0000X	Nurse Practitioner	Family	71000959A	INDIANA	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	P54690	MEDICARE UPIN
2	P01016729	OTHER	INDIANA	RR MEDICARE PTAN
3	232230QQQ	MEDICARE UPIN	INDIANA
4	200307710	MEDICAID	INDIANA
5	213820D	MEDICARE PIN	INDIANA
6	192980B	MEDICARE ID-TYPE UNSPECIFIED	INDIANA

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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