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Individual

AMANDA CLARK

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
CNP

Contact information

Practice address
2139 AUBURN AVE, CINCINNATI, OH 45219-2906
(513) 206-1180
Mailing address
237 WILLIAM HOWARD TAFT RD, 2ND FLOOR, CBO 2-3, CINCINNATI, OH 45219-2610
(513) 206-1180

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN302986
OH
363LA2100X
Acute Care Nurse Practitioner
Primary
NP-019707
OH

Other

Enumeration date
07/28/2016
Last updated
08/18/2016
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