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General NPI Number Information
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NPI Number | 1114475456
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Entity Type | Individual
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Provider Name | KAREN SUE CLARKSON FNP
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Gender | Female
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Dates
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Enumeration Date | 09/15/2016
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Last Update Date | 10/28/2024
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Provider Practice Location Address
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Address Line | 3900 HULL STREET RD
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City | RICHMOND
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State | VA
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Zip | 23224-1714
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Country | US
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Telephone | 804-292-7620
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 746871
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City | ATLANTA
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State | GA
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Zip | 30374-6871
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Country | US
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Telephone | 469-727-6675
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 0024190593
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 64630
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License Number State | TN
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