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Individual

BERNICE MONIQUE CLARK

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
APRN

Contact information

Practice address
60205 BODNAR BLVD, MISHAWAKA, IN 46544-9342
(574) 325-5961
Mailing address
1133 OBRIEN ST, SOUTH BEND, IN 46628-2541
(574) 217-6906

Taxonomy

Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
71016172A
IN
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
71016172A
IN

Other

Enumeration date
12/30/2024
Last updated
07/29/2025
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