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Nicole Clark
Student in an Organized Health Care Education/Training Program in Southfield, Michigan
NPI 1013624998

Nicole Clark is a Student in an Organized Health Care Education/Training Program based in Southfield, MI. Nicole Clark practices in Southfield, MI. The NPI Number for Nicole Clark is 1013624998 and holds a License No. (Michigan).

The current practice location address for Nicole Clark is 20201 Alhambra St, Southfield, MI and can be reached out via phone at 248-592-4108.

Location: 20201 Alhambra St, Southfield, MI, 48076-5420
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1013624998
Provider Name
Nicole Clark
Credential
Provider Entity Type
Individual
Gender
Female
Address
20201 Alhambra St, Southfield, MI, 48076-5420
Phone Number
248-592-4108
Fax Number
Provider Enumeration Date
11/01/2022
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
20201 Alhambra St
City
Southfield
State
Michigan
Zip
48076-5420
Phone Number
248-592-4108
Fax Number
person
Provider Business Mailing Address Details
Address
20201 Alhambra St
City
Southfield
State
Michigan
Zip
48076-5420
Phone Number
248-592-4108
Fax Number
person
Provider's Taxonomy Details 1
Type
Student, Health Care
Classification
Student in an Organized Health Care Education/Training Program
Speciality
-
Taxonomy
390200000X
License No.
()
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
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