Individual provider · NPI-1

Zina Renee Clark

Registered Nurse, Gerontology · Memphis, TN

NPI number1508456096
StatusActive
Last updated in NPPESJan 19, 2021

Details

NPI
1508456096
Entity type
Individual (NPI-1)
Name
Zina Renee Clark
Sex
Female
Sole proprietor
Yes
Enumeration date
Jan 19, 2021
Certification date
Jan 19, 2021
Last updated
Jan 19, 2021

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
163WG0600X Registered Nurse, Gerontology0000085468TNYes
163WP0809X Registered Nurse, Psych/Mental Health, Adult0000085468TN

Practice location

7264 Hunters Tree Dr
Memphis, TN 38125-4807

Phone 901-292-4407

Mailing address

7264 Hunters Tree Dr
Memphis, TN 38125-4807

Phone 901-292-4407

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