Kerese Jodianne Clarke | Bronx, NY • PECOS Search

Kerese Jodianne Clarke

Registered Nurse

Nursing Service Providers

1033 E 219th St, Bronx, NY 10469-1201

PECOS Enrollment

Based on the most recent information from CMS, provider Kerese Jodianne Clarke does not have current enrollment records in PECOS.

Part B
Medicare Part B
Not Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Not Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records 7 days ago.

Profile Details

Provider ID
1831466804
Provider Type
Individual
Full Name
Clarke, Kerese Jodianne
Gender
Female

Sole Proprietor
Yes
Enumeration Date
11/18/2011
Last Updated
11/18/2011

Contact Information

Practice Location

1033 E 219th St, Bronx, NY 10469-1201

Unlisted Fax

Mailing Location

1033 E 219th St, Bronx, NY 10469-1201

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 163W00000X Primary	Description Registered Nurse Nursing Service Providers	License 648564 New York