Individual
MELISSA CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
410 W 10TH AVE FL 1, COLUMBUS, OH 43210-1240
(614) 293-8487
(614) 293-8153
Mailing address
700 ACKERMAN RD STE 2120, COLUMBUS, OH 43202-1559
(614) 293-8487
(614) 293-8153
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN.372889
OH
367500000X
Certified Registered Nurse Anesthetist
Primary
APRN.CRNA.0020839
OH
Other
Enumeration date
06/30/2021
Last updated
05/30/2024
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