Individual
AMANDA LYNN CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
122 PARK AVE, SCHENECTADY, NY 12304-1628
(518) 346-2387
Mailing address
204 GLEBE ST, JOHNSTOWN, NY 12095-2515
(518) 224-8452
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
329692
NY
164W00000X
Licensed Practical Nurse
PN5249837
FL
Other
Enumeration date
10/03/2022
Last updated
10/05/2022
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