| Raven Clark, NP | |
|
100 Piedmont Rd Ne, Marietta, GA 30066-3636 | |
| (770) 795-9844 | |
| Not Available |
| Full Name | Raven Clark |
|---|---|
| Gender | Female |
| Speciality | Nurse Practitioner |
| Experience | 5 Years |
| Location | 100 Piedmont Rd Ne, Marietta, Georgia |
| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1427776160 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363L00000X | Nurse Practitioner | RN259021 (Georgia) | Primary |
| 363LF0000X | Nurse Practitioner - Family | RN259021 (Georgia) | Secondary |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Minuteclinic Llc | 6709850241 | 576 |
| Entity Name | Minuteclinic LLC |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1134191836 PECOS PAC ID: 6709850241 Enrollment ID: O20051024000186 |
| Entity Name | Primary Care PLLC |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1770354763 PECOS PAC ID: 0941642169 Enrollment ID: O20241106000482 |
| Mailing Address | Practice Location Address |
|---|---|
| Raven Clark, NP 100 Piedmont Rd Ne, Marietta, GA 30066-3636 Ph: Not Available | Raven Clark, NP 100 Piedmont Rd Ne, Marietta, GA 30066-3636 Ph: (770) 795-9844 |
Mrs. Jennifer Irene Sarno, ACNP-BC Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 780 Canton Rd Ne, Suite 400, Marietta, GA 30060 Phone: 770-422-3602 |
Donna Marie Liming, WHNP-BC Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 3405 Dallas Hwy Sw Ste 200, Marietta, GA 30064 Phone: 678-802-8665 Fax: 678-540-4250 |
Stacey Glass Malstrom, NP-C Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 55 Whitcher St Ne Ste 350, Marietta, GA 30060 Phone: 770-424-6893 |
Tanisha Leonard, AGACNP-BC Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 55 Whitcher St Ne Ste 350, Marietta, GA 30060 Phone: 770-424-6893 Fax: 770-528-9938 |
Julie J Baute, APRN Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 780 Canton Rd Ne Ste 205, Marietta, GA 30060 Phone: 678-224-6198 |
Dr. Ibisa Comfort Onyirimba, DNP, FNP-C, APRN Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 2481 Hurt Rd Sw, Marietta, GA 30008 Phone: 404-934-2420 |
Mrs. Susan Wanjiku Kamau, FNP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 1579 Sage Ridge Dr, Marietta, GA 30064 Phone: 404-643-0444 |