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Individual

STACEY LYNN CLARK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
RN

Contact information

Practice address
9709 LINCOLN HWY, BEDFORD, PA 15522
(814) 652-3220
Mailing address
209 W JOHN ST, BEDFORD, PA 15522-1711
(814) 617-0028

Taxonomy

Speciality
Code
Description
License number
State
163WC0400X
Case Management Registered Nurse
Primary
RN696926
PA

Other

Enumeration date
06/27/2018
Last updated
07/19/2018
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