Individual
MRS. DENEAN ELIZABETH CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
20104 NYS RT 3, WATERTOWN, NY 13601-5560
(315) 779-7000
(315) 779-7109
Mailing address
PO BOX 30, COPENHAGEN, NY 13626-0030
(315) 688-4411
(315) 688-2001
Taxonomy
Speciality
Code
Description
License number
State
163WS0200X
School Registered Nurse
Primary
566653
NY
163WS0200X
School Registered Nurse
5666531
NY
Other
Enumeration date
12/01/2011
Last updated
06/11/2025
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