Individual
ELIZABETH ANN CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
200 BAILEY DR STE 201B, STEWARTSTOWN, PA 17363-8399
(443) 692-7991
(717) 276-9018
Mailing address
200 BAILEY DR STE 201B, STEWARTSTOWN, PA 17363-8399
(443) 692-7991
(717) 276-9018
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
0024197347
VA
207Q00000X
Family Medicine Physician
021609
OH
208100000X
Physical Medicine & Rehabilitation Physician
R256198
MD
363LF0000X
Family Nurse Practitioner
Primary
SP018007
PA
Other
Enumeration date
10/25/2017
Last updated
07/13/2026
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