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CELESTE CLARK RN

Case Management >> Registered Nurse >> Nursing Service Providers

Registrant NPI Number: 1285866939

Individual Registrant:
 CELESTE  CLARK RN
Gender: F
Not Sole Proprietor

Location and contact information for practice:
5342 DUDLEY BLVD # 98  MCCLELLAN, CA 95652-1012 US
Tel: 916-561-7520  Fax: --

Contact information for business:
5200 BRONDSBURY LN  FAIR OAKS, CA 95628-4087 US
Tel: 916-561-7520  Fax: --

Registration Information:
NPI: 1285866939
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y163WC0400XNursing Service Providers
Registered Nurse
Case Management
AZRN146571

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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