KELLY PATRICIA CLARK LPN
NPI 1013474410
Licensed Practical Nurse in Mason, MI

Q: What is Kelly Clark's NPI number?

The NPI number for Kelly Clark is 1013474410. It was assigned to this individual provider in the NPPES registry on February 22, 2019.

Q: What is Kelly Clark's specialty?

The primary specialty registered for this NPI is Licensed Practical Nurse with taxonomy code 164W00000X.

Q: When was this NPI record last updated?

The NPPES record for Kelly Clark was last updated on February 22, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 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.

Active since February 22, 2019

55 PINE DR E, MASON, MI 48854(517) 394-6484 Get Directions Write a Review

NPPES record last updated: February 22, 2019. Verified against the NPPES registry weekly; last sync: August 02, 2026.

On this page

About Kelly Patricia Clark Lpn NPPES

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

KELLY PATRICIA CLARK LPN (NPI 1013474410) is an individual licensed practical nurse in Mason, Michigan, licensed in Michigan (4703110786) and active in the NPI registry since February 2019.

NPPES Registry Identity

NPI1013474410

Entity TypeIndividualFemale

Primary Taxonomy164W00000X

Provider Legal NameKELLY PATRICIA CLARKCredential: LPN

Location Address55 PINE DR EMason, MI 48854-9229

Mailing Address55 Pine Dr EMason, MI 48854-9229 · (517) 394-6484

Phone(517) 394-6484

Sole ProprietorYes

Enumeration DateFebruary 22, 2019

✔ NPI 1013474410 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyLicensed Practical NurseNursing Service Providers

Taxonomy Code164W00000X

License✔ Licensed in MI · 4703110786

Definition

A licensed practical nurse with post-high school vocational training and practical experience in the provision of nursing care at a level less than that required for certification as a Registered Nurse. Requirements for education, experience, licensure, and job responsibilities vary among the states.

55 PINE DR E, Mason, MI 48854

Open in Google Maps ↗

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 Kelly Clark's NPI number?

The NPI number for Kelly Clark is 1013474410. It was assigned to this individual provider in the NPPES registry on February 22, 2019.

Where is Kelly Clark located?

Kelly Clark practices at 55 Pine Dr E, Mason, MI 48854. The listed phone number is (517) 394-6484.

What is Kelly Clark's specialty?

The primary specialty registered for this NPI is Licensed Practical Nurse with taxonomy code 164W00000X.

When was this NPI record last updated?

The NPPES record for Kelly Clark was last updated on February 22, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 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.