Miss Crystal B Clark, FNP-C is a
Nurse Practitioner - Family physician based in Pageland, South Carolina. Miss Crystal B Clark is licensed to practice in South Carolina (license number 22378) and her current practice location is 211 S Pearl St, Pageland, South Carolina. She can be reached at her office (for appointments etc.) via phone at
(803) 288-9495.
NPI number for Miss Crystal B Clark is 1154898179 and her current mailing address is 2223 Camp Creek Rd, Lancaster, South Carolina. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1154898179.
Physician's Profile
| Full Name | Miss Crystal B Clark |
|---|
| Gender | Female |
|---|
| Speciality | Nurse Practitioner - Family |
|---|
| Location | 211 S Pearl St, Pageland, South Carolina |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
|---|
NPI Data:
- NPI Number: 1154898179
- Provider Enumeration Date: 10/29/2018
- Last Update Date: 12/08/2025
Medical Identifiers
Medical identifiers for Miss Crystal B Clark such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1154898179 | NPI | - | NPPES |
| 5422378 | Other | SC | CONTROLLED SUBSTANCE LICENSURE |
| 22378 | Other | SC | APRN LICENSURE |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 208000000X | Pediatrics | 22378 (South Carolina) | Secondary |
| 363LF0000X | Nurse Practitioner - Family | 22378 (South Carolina) | Primary |
| 363LA2100X | Nurse Practitioner - Acute Care | 22378 (South Carolina) | Secondary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Miss Crystal B Clark is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Miss Crystal B Clark, FNP-C
2223 Camp Creek Rd,
Lancaster, SC 29720-8511
Ph: (704) 292-3651 | Miss Crystal B Clark, FNP-C
211 S Pearl St,
Pageland, SC 29728-2261
Ph: (803) 288-9495 |
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