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NPI Profile for BRENDA B CLARK in WENTWORTH, NC.
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Surgical |
363AS0400X | 97 | Physician Assistant |
| NPI # | 1417979576 |
|
| Status | Active | |
| Credentials | PHYSICIANS ASSISTANT | |
| Entity | Individual | |
| Enumeration date | 07/24/2006 | |
| Last updated | 07/03/2008 - About 18 years ago | |
| Sole proprietor 1 | No | |
| Identifiers |
|
|
| Hospital affiliation(s) | Not Available |
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BRENDA B CLARK
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BRENDA B CLARK, PHYSICIANS ASSISTANT