Individual
MRS. MARY ELIZABETH CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
26 NESBITT RD STE 100, NEW CASTLE, PA 16105-3417
(724) 983-1611
Mailing address
3915 FAIRWAY DR, CANFIELD, OH 44406-9055
(330) 360-5703
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN.405714
OH
163W00000X
Registered Nurse
RN780193
PA
363LF0000X
Family Nurse Practitioner
APRN.CNP.022539
OH
363LF0000X
Family Nurse Practitioner
Primary
SP028452
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0274317
—
OH
Enumeration date
01/26/2018
Last updated
01/25/2024
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