Individual
MRS. BRITTANY KAY CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP-C
Contact information
Practice address
1258 BELLEFONTAINE ST STE A, WAPAKONETA, OH 45895
(419) 739-1980
(419) 739-1982
Mailing address
1258 BELLEFONTAINE ST, WAPAKONETA, OH 45895-9775
(419) 739-1980
(419) 739-1982
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
COA.16412-NP
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0113150
—
OH
01
—
H401061
MEDICARE PIN
OH
Enumeration date
08/19/2014
Last updated
12/01/2020
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