Individual
MRS. MEREDITH CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNP
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
11696
OH
363LF0000X
Family Nurse Practitioner
11696NP
OH
Other
Enumeration date
09/17/2010
Last updated
04/02/2020
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