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NPI Code Detail

MEDICARE: SHARONDA CLARK RN

MEDICARE:   SHARONDA  CLARK  RN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1163W00000XRegistered Nurse2534162MN

General Provider Information

NPI Number : 1275482077
Entity Type Code : Individual
Provider Name (Legal Business Name) : SHARONDA CLARK RN
Provider Business Mailing Address
First Line : 936 41ST ST NW # C102
Second Line :
City : ROCHESTER
State : MN
Zip : 55901-4246
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 936 41ST ST NW
Second Line :
City : ROCHESTER
State : MN
Zip : 55901-4246
Country : US
Telephone Number : 773-816-9567
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/26/2026
Last Update Date : 01/26/2026

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