National Provider Identifier Database

DEBRA A CLARK, RN – NPI #1508079328
Pediatrics


Contact Information

DEBRA A CLARK, RN
2044 MADISON AVE
SUITE G7
GRANITE CITY, IL62040-4641
Phone: 618-451-6685
Fax: 618-451-7292
Website:
Specialty Taxonomy Code
* Pediatrics 163WP0200X

* Indicates primary specialty

NPI Profile & details for DEBRA A CLARK

NPI Number 1508079328
Credentials RN (Registered Nurse)
Entity Individual
Enumeration date 05/08/2007
Last updated 07/08/2007 - About 19 years ago
Sole proprietor1 No
Identifiers n/a
Hospital affiliation n/a

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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