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General NPI Number Information
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NPI Number | 1992195853
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Entity Type | Individual
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Provider Name | PATRICIA TERESA CLARKE RN
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Gender | Female
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Dates
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Enumeration Date | 01/30/2015
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Last Update Date | 10/28/2025
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Provider Practice Location Address
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Address Line | 195 TRIUMPH DR NW # 30327
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City | ATLANTA
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State | GA
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Zip | 30327-1050
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Country | US
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Telephone | 845-926-6863
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Fax |
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Provider Business Mailing Address
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Address Line | 195 TRIUMPH DR NW # 30327
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City | ATLANTA
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State | GA
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Zip | 30327-1050
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Country | US
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Telephone | 845-926-6863
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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 | 101YP1600X
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Taxonomy Name | Pastoral Counselor
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License Number |
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 163WC0400X
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Taxonomy Name | Case Management Registered Nurse
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License Number | 298672
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License Number State | GA
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