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Contact Information

CHARLES P CLARK, CRNA
120 RIVERVIEW ST
FRANKLIN, NC28744
 Phone: 828-524-8411
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Registered Nurse

163W00000X
Indicates primary specialty

NPI Profile & details for CHARLES P CLARK · (Male)

NPI Number 1588684625
Status Active
Credentials CRNA (Certified Registered Nurse Anesthetist)
Entity Individual
Enumeration date 07/20/2006
Last updated 07/09/2009 - About 17 years ago
Sole proprietor 1 Yes
Identifiers
  • NC License # 151205
  • GA Medicaid 986074426A
  • NC Medicaid 8052336
  • NC Other P00289782 RAILROAD MEDICARE
Hospital affiliation(s) Not Available
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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