RENNA CLARK NURSE PRACTITIONER NPI 1992428361

NPI Information

NPI: 1992428361
Provider Name: RENNA CLARK, NURSE PRACTITIONER
Classification: Nurse Practitioner - 363LW0102X
Entity Type: Individual

Specialization: Women's Health

PECOS Registration: Yes

Address:
3775 FETTLER PARK DR UNIT A5
DUMFRIES, VA
ZIP 22025
Phone: (703) 441-3555
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Renna Clark, NURSE PRACTITIONER is a women's health nurse practitioner in Dumfries, VA. Renna Clark, NURSE PRACTITIONER NPI is 1992428361. 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:

3775 FETTLER PARK DR UNIT A5
DUMFRIES, VA
ZIP 22025-946
Phone: (703) 441-3555

The NPI 1992428361 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 9/21/2022 and was last updated on 1/17/2024.

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	363LW0102X	Nurse Practitioner	Women's Health	0024184881	VIRGINIA	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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