Miss Crystal B Clark, FNP-C is a
Family Medicine 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 Ste B, 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 211 S Pearl St Ste B, Pageland, South Carolina. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1154898179.
Provider's Profile
| Full Name | Miss Crystal B Clark |
|---|
| Gender | Female |
|---|
| Speciality | Family Medicine |
|---|
| Location | 211 S Pearl St Ste B, Pageland, South Carolina |
|---|
| 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: 03/08/2026
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 |
| 363LF0000X | Nurse Practitioner - Family | 22378 (South Carolina) | Secondary |
| 207Q00000X | Family Medicine | 22378 (South Carolina) | 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. 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 211 S Pearl St Ste B, Pageland, SC 29728-2261 Ph: (843) 675-5070 | Miss Crystal B Clark, FNP-C 211 S Pearl St Ste B, Pageland, SC 29728-2261 Ph: (803) 288-9495 |
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