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Contact Information

NICOLE CLARK, HAIR LOSS SPECIALIST
100 N BURKE AVE
LONG BEACH, MS39560-4605
 Phone: 228-234-1658
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Prosthetist

224P00000X 56 Individual Certified Prosthetist
Indicates primary specialty

NPI Profile & details for NICOLE CLARK · (Female)

NPI # 1386106375
Status Active
Credentials HAIR LOSS SPECIALIST
Entity Individual
Enumeration date 04/01/2019
Last updated 04/01/2019 - About 7 years ago
Sole proprietor 1 Yes
Identifiers Not Available
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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