MRS. SUSAN LOUISE CLARK NP NPI 1043525025

NPI Information

NPI: 1043525025
Provider Name: MRS. SUSAN LOUISE CLARK, NP
Classification: Nurse Practitioner - 363LP0808X
Entity Type: Individual

Specialization: Psychiatric/Mental Health

PECOS Registration: Yes

Address:
5701 BOW POINTE DR
SUITE 225
CLARKSTON, MI
ZIP 48346
Phone: (248) 384-8300
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MRS. Susan Louise Clark, NP is a psychiatric/mental health nurse practitioner in Clarkston, MI. MRS. Susan Louise Clark, NP NPI is 1043525025. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

5701 BOW POINTE DR
SUITE 225
CLARKSTON, MI
ZIP 48346-198
Phone: (248) 384-8300
Fax: (248) 384-8309

The NPI 1043525025 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 8/13/2010 and was last updated on 8/13/2010.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363LA2200X	Nurse Practitioner	Adult Health	4704201015	MICHIGAN	No
2	363LP0808X	Nurse Practitioner	Psychiatric/Mental Health	4704201015	MICHIGAN	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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