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Ms. Nicollette Shautria Clark
Attendant Care Provider in Monticello, Mississippi
NPI 1831746817

Nicollette Shautria Clark is an Attendant Care Provider based in Monticello, MS and is specialized in Attendant Care Provider. Nicollette Shautria Clark practices in Monticello, MS. The NPI Number for Nicollette Shautria Clark is 1831746817 and holds a License No. (Mississippi).

The current practice location address for Nicollette Shautria Clark is 940 Neal Pl, Monticello, MS and can be reached out via phone at 601-522-9025.

Location: 940 Neal Pl, Monticello, MS, 39654-7003
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1831746817
Provider Name
Nicollette Shautria Clark
Credential
Provider Entity Type
Individual
Gender
Female
Address
940 Neal Pl, Monticello, MS, 39654-7003
Phone Number
601-522-9025
Fax Number
Provider Enumeration Date
08/23/2019
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
940 Neal Pl
City
Monticello
State
Mississippi
Zip
39654-7003
Phone Number
601-522-9025
Fax Number
person
Provider Business Mailing Address Details
Address
940 Neal Pl
City
Monticello
State
Mississippi
Zip
39654-7003
Phone Number
601-522-9025
Fax Number
person
Provider's Taxonomy Details 1
Type
Nursing Service Related Providers
Classification
Technician
Speciality
Attendant Care Provider
Taxonomy
3747A0650X
License No.
(Mississippi)
Definition
An individual who provides hands-on care, of both a supportive and health related nature, specific to the needs of a medically stable, physically handicapped individual. Supportive services are those that substitute for the absence, loss, diminution, or impairment of a physical or cognitive function. This service may include skilled or nursing care to the extent permitted by state law.
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