Individual
ERIC CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
201 STATE ST, ERIE, PA 16550-0002
(814) 877-2938
Mailing address
201 STATE ST, ERIE, PA 16550-0002
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN715563
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
RN715563
RNLICENSE
PA
Enumeration date
10/27/2025
Last updated
10/27/2025
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