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General NPI Number Information
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NPI Number | 1801542592
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Entity Type | Individual
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Provider Name | LINDA MARIE CLARK RN
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Gender | Female
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Dates
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Enumeration Date | 02/22/2022
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Last Update Date | 02/22/2022
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Provider Practice Location Address
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Address Line | 56 SHARON CT
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City | METUCHEN
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State | NJ
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Zip | 08840-1730
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Country | US
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Telephone | 732-734-7406
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Fax | 732-452-4133
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Provider Business Mailing Address
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Address Line | 56 SHARON CT
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City | METUCHEN
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State | NJ
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Zip | 08840-1730
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Country | US
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Telephone | 732-734-7406
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Fax | 732-452-4133
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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 | 163WG0600X
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Taxonomy Name | Gerontology Registered Nurse
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License Number | 26NR13150400
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License Number State | NJ
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