Kelly S Clark, LPN is a
Licensed Vocational Nurse based in Middlefield, Ohio. Kelly S Clark is licensed to practice in Ohio (license number 131431) and her current practice location is
15716 W High St # 597, Middlefield, Ohio. She can be reached at her office (for appointments etc.) via phone at
(440) 632-8071.
NPI number for Kelly S Clark is 1538479324 and her current mailing address is 15716 W High St, P O Box 597, Middlefield, Ohio. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1538479324.
Provider's Profile
| Full Name | Kelly S Clark |
|---|
| Gender | Female |
|---|
| Speciality | Licensed Vocational Nurse |
|---|
| Location | 15716 W High St # 597, Middlefield, Ohio |
|---|
| Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
NPI Data:
- NPI Number: 1538479324
- Provider Enumeration Date: 10/14/2010
- Last Update Date: 10/14/2010
Medical Identifiers
Medical identifiers for Kelly S Clark such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
| 1538479324 | NPI | - | NPPES |
| 0000 | Other | | APPLYING FOR NUMBER NOW. |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
| 164X00000X | Licensed Vocational Nurse | 131431 (Ohio) | Primary |
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. Kelly S 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 |
Kelly S Clark, LPN 15716 W High St, P O Box 597, Middlefield, OH 44062-9201 Ph: (440) 632-8071 | Kelly S Clark, LPN 15716 W High St # 597, Middlefield, OH 44062-9201 Ph: (440) 632-8071 |
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