National Provider Identifier

Reeda Irene Clark, LPN

Reeda Irene Clark, LPN is listed in the NPPES registry with a primary specialty of Licensed Practical Nurse in Erin, NY and a listed phone number of (607) 739-1504.

NPI 1821296369Erin, NYLicensed Practical Nurse

Profile Overview

NPI
1821296369
Provider Type
Individual
Primary Specialty
Licensed Practical Nurse
Enumeration Date
July 06, 2007
Last Updated
July 09, 2007

Practice Location

  • 236 Park Station RD
  • Erin, NY 14838-9735

Phone: (607) 739-1504

Specialties

  • Licensed Practical Nurse (164W00000X)
Full Record
NPI
1821296369
Entity Type
Individual
Last Name
Clark
First Name
Reeda
Middle Name
Irene
Name Prefix
MS.
Credential
LPN
Mailing Street Address
236 Park Station RD
Mailing City
Erin
Mailing State
NY
Mailing ZIP Code
14838-9735
Mailing Country
US
Mailing Phone
(607) 739-1504
Practice Street Address
236 Park Station RD
Practice City
Erin
Practice State
NY
Practice ZIP Code
14838-9735
Practice Country
US
Practice Phone
(607) 739-1504
Enumeration Date
July 06, 2007
Last Updated
July 09, 2007
Sex
Female
Sole Proprietor
Yes
updated_by_file
npidata_pfile_20050523-20260308.csv
Taxonomies
Licensed Practical Nurse (164W00000X)
Other Identifiers
01223427 (NY)