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YETTA HARDY CLARK CRNA
NPI 1013029461
Nurse Anesthetist, Certified Registered in Winston Salem, NC

Active since August 31, 2006
145 KIMEL PARK DR, SUITE 300, WINSTON SALEM, NC 27103(336) 768-3212(336) 768-9019 Get Directions Write a Review

NPPES record last updated: July 8, 2007. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Yetta Hardy Clark Crna NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

YETTA HARDY CLARK CRNA (NPI 1013029461) is an individual nurse anesthetist, certified registered in Winston Salem, North Carolina, licensed in North Carolina (043294) and active in the NPI registry since August 2006.

NPPES Registry Identity

NPI1013029461
Entity TypeIndividualFemale
Primary Taxonomy367500000X
Provider Legal NameYETTA HARDY CLARKCredential: CRNA
Location Address145 KIMEL PARK DR, SUITE 300Winston Salem, NC 27103-6984
Mailing Address145 Kimel Park Dr, Suite 300Winston Salem, NC 27103-6984 · (336) 768-3212 · Fax (336) 768-9019
Phone(336) 768-3212
Fax(336) 768-9019
Sole ProprietorNo
Enumeration DateAugust 31, 2006
Last NPPES UpdateJuly 8, 2007
✔ NPI 1013029461 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Anesthetist, Certified RegisteredPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code367500000X
License✔ Licensed in NC · 043294
Definition
(1) A licensed registered nurse with advanced specialty education in anesthesia who, in collaboration with appropriate health care professionals, provides preoperative, intraoperative, and postoperative care to patients and assists in management and resuscitation of critical patients in intensive care, coronary care, and emergency situations. Nurse anesthetists are certified following successful completion of credentials and state licensure review and a national examination directed by the Council on Certification of Nurse Anesthetists. (2) A registered nurse who is qualified by special training to administer anesthesia in collaboration with a physician or dentist and who can assist in the care of patients who are in critical condition.
145 KIMEL PARK DR, Winston Salem, NC 27103
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Other Identifiers 2

Medicaid8051731NC
Medicare ID-Type Unspecified261057DNC

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

CARIE SUE NUNLEY CRNA
Nurse Anesthetist, Certified Registered
145 KIMEL PARK DR, SUITE 120
WINSTON SALEM, NC 27103
Forsyth County (336) 768-3212
HOLLY C PEGRAM CRNA
Nurse Anesthetist, Certified Registered
145 KIMEL PARK DR, SUITE 120
WINSTON SALEM, NC 27103
Forsyth County (336) 768-3212
TRAVIS HAROLD JACKSON MD
Psychiatry & Neurology (Neurology)
145 KIMEL PARK DR, SUITE 100
WINSTON-SALEM, NC 27103
Forsyth County (336) 768-6347
PEGGY B BRANCH CRNA
Nurse Anesthetist, Certified Registered
145 KIMEL PARK DR, SUITE 300
WINSTON SALEM, NC 27103
Forsyth County (336) 768-3212
MARCUS ANTHONY HELMS CRNA
Nurse Anesthetist, Certified Registered
145 KIMEL PARK DR, SUITE 120
WINSTON SALEM, NC 27103
Forsyth County (336) 768-3212
PEGGY LEE JONES CRNA
Nurse Anesthetist, Certified Registered
145 KIMEL PARK DR, SUITE 300
WINSTON SALEM, NC 27103
Forsyth County (336) 768-3212
BENJAMIN JOSEPH BOEHNLEIN CRNA
Nurse Anesthetist, Certified Registered
145 KIMEL PARK DR, SUITE 120
WINSTON SALEM, NC 27103
Forsyth County (336) 768-3212
KRISTINA LOUISE FOARD CRNA
Nurse Anesthetist, Certified Registered
145 KIMEL PARK DR, SUITE 120
WINSTON SALEM, NC 27103
Forsyth County (336) 768-3212

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Yetta Clark's NPI number?

The NPI number for Yetta Clark is 1013029461. It was assigned to this individual provider in the NPPES registry on August 31, 2006.

Where is Yetta Clark located?

Yetta Clark practices at 145 Kimel Park Dr Suite 300, Winston Salem, NC 27103. The listed phone number is (336) 768-3212.

What is Yetta Clark's specialty?

The primary specialty registered for this NPI is Nurse Anesthetist, Certified Registered with taxonomy code 367500000X.

When was this NPI record last updated?

The NPPES record for Yetta Clark was last updated on July 8, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.