Ricketta Clark in Memphis - Nurse Practitioner
Ricketta Clark - NPI 1558478933
Ricketta Clark is a Nurse Practitioner in Memphis, Tennessee. Ricketta Clark practices all healthcare services and medical treatments related to Nurse Practitioner. The NPI Number for Ricketta Clark is 1558478933. The last update date is 2021-11-09.
Ricketta Clark's current location address is 880 Madison Ave, Memphis, Tennessee. You can contact this provider via phone number 9014907929. The mailing address for Ricketta Clark is 880 Madison Ave, Memphis, Tennessee. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Ricketta Clark |
|---|---|
| Address | 880 Madison Ave, Memphis, Tennessee |
| Phone Number | 9014907929 |
| Fax Number | |
| Sole Proprietor | N |
| Credentials | NP |
NPI Number Detail
| NPI Number | 1558478933 |
|---|---|
| Provider Enumeration Date | 2006-08-23 |
| Last Updated Date | 2021-11-09 |
Provider Mailing Address Detail
| Address | 880 Madison Ave |
|---|---|
| City | Memphis |
| State | Tennessee (TN) |
| Post Code | 381033409 |
| Phone Number | 9014907929 |
| Fax Number |
Provider's Primary Taxonomy Detail
| Speciality | Nurse Practitioner |
|---|---|
| Taxonomy | 363L00000X |
| Licence No | 7029 |
|
Definition: (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certifi |
|
Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 3905917 | TN | -- |
Post Comment/ Review Below
What is the unique 10-digit identification code issued to Ricketta Clark by the Centers for Medicare & Medicaid Services?
The Ricketta Clark has been assigned the NPI (National Provider Identifier) 1558478933 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code serves as a unique identifier for healthcare providers.
Could you please provide the complete physical location address of Ricketta Clark?
The Ricketta Clark is physically situated at 880 Madison Ave, in the city of Memphis, state of TN, with the postal code 381033409.
What is Ricketta Clark's specialized field of practice, and what is the corresponding taxonomy classification code?
The Ricketta Clark's area of specialization is Nurse Practitioner, and the corresponding taxonomy code that categorizes this field of practice is 363L00000X.
On what date was the 1558478933 assigned to Ricketta Clark?
The Ricketta Clark was issued its 1558478933 on 2006-08-23, which is the date when this unique identifier was assigned to the organization by the Centers for Medicare & Medicaid Services.
When was the information related to Ricketta Clark most recently updated or refreshed?
The details pertaining to the Ricketta Clark, including its address, specialty, and other relevant information, were last updated or refreshed on 2021-11-09.