Individual
LORI CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ACNP
Contact information
Practice address
630 E RIVER ST, ELYRIA, OH 44035-5902
(440) 329-7500
Mailing address
6347 LIVIA LN, MEDINA, OH 44256-7765
(440) 454-0708
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
026206
OH
363LC0200X
Critical Care Medicine Nurse Practitioner
Primary
APRN.CNP.026206
OH
Other
Enumeration date
02/07/2020
Last updated
02/13/2020
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