Individual
ELIZABETH ANN CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
18 BURNS RD, SPRING GROVE, PA 17362-8359
(330) 319-1536
Mailing address
18 BURNS RD, SPRING GROVE, PA 17362-8359
(330) 319-1536
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
R256198
MD
363LF0000X
Family Nurse Practitioner
Primary
SP018007
PA
Other
Enumeration date
10/25/2017
Last updated
04/03/2026
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