Individual
SHANEEKA CLARKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
970 ROUTE 196 UNIT 6, TOBYHANNA, PA 18466-8208
(272) 336-9157
Mailing address
2870 FAIRHAVEN DR, TOBYHANNA, PA 18466-3765
(272) 336-9147
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
PN307649
PA
Other
Enumeration date
11/28/2022
Last updated
11/28/2022
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