Kelly Sue Clark, REGISTERED NURSE is a
Registered Nurse based in Metropolis, Illinois. Kelly Sue Clark is licensed to practice in Illinois (license number 041405442) and her current practice location is
28 Chick St, Metropolis, Illinois. She can be reached at her office (for appointments etc.) via phone at
(618) 524-2176.
NPI number for Kelly Sue Clark is 1598253361 and her current mailing address is 320 Lindsey Ave, Metropolis, Illinois. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1598253361.
Provider's Profile
Full Name | Kelly Sue Clark |
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Gender | Female |
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Speciality | Registered Nurse |
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Location | 28 Chick St, Metropolis, Illinois |
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Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
NPI Data:
- NPI Number: 1598253361
- Provider Enumeration Date: 04/27/2018
- Last Update Date: 04/27/2018
Medical Identifiers
Medical identifiers for Kelly Sue Clark such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1598253361 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
163W00000X | Registered Nurse | 041405442 (Illinois) | 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 Sue 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 Sue Clark, REGISTERED NURSE 320 Lindsey Ave, Metropolis, IL 62960-1162 Ph: () - | Kelly Sue Clark, REGISTERED NURSE 28 Chick St, Metropolis, IL 62960-2467 Ph: (618) 524-2176 |
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