Individual
TERRI L CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
1 MEDICAL PARK, WHEELING, WV 26003-6379
(304) 243-3343
Mailing address
PO BOX 354, RAYLAND, OH 43943-0354
(740) 633-2556
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
44069
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0066297000
—
WV
05
—
2300147
—
OH
Enumeration date
07/13/2006
Last updated
07/08/2007
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