Individual
CHAUNDREA NICOLE CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
STNA
Contact information
Practice address
11200 PARKVIEW AVE, APARTMENT 4, CLEVELAND, OH 44104-5074
(216) 231-4682
Mailing address
11200 PARKVIEW AVE, APARTMENT 4, CLEVELAND, OH 44104-5074
(216) 231-4682
Taxonomy
Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
401021201209
OH
Other
Enumeration date
04/21/2011
Last updated
04/21/2011
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