Individual
NICOLE MARIE CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
1141 MANTUA PIKE, MANTUA, NJ 08051-1608
(732) 456-7777
Mailing address
1141 MANTUA PIKE, MANTUA, NJ 08051-1608
(732) 456-7777
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
26NJ01365300
NJ
Other
Enumeration date
09/09/2022
Last updated
09/09/2022
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