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General NPI Number Information
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NPI Number | 1407098411
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Entity Type | Individual
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Provider Name | MRS. LINDSEY ANNE CLARK
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Gender | Female
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Dates
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Enumeration Date | 04/06/2009
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Last Update Date | 07/16/2024
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Provider Practice Location Address
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Address Line | 2435 FOREST DR
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City | COLUMBIA
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State | SC
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Zip | 29204-2026
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Country | US
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Telephone | 803-256-5300
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Fax |
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Provider Business Mailing Address
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Address Line | 129 NORTH WASHINGTON STREET
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City | SUMTER
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State | SC
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Zip | 29150
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Country | US
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Telephone | 803-774-8726
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Fax | 803-774-9846
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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 | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | 3877
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License Number State | SC
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