Individual
ELISHA ANNE CLARK
Active
Individual
ELISHA ANNE CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Taxonomy
Speciality
Code
Description
License number
State
163WW0000X
Wound Care Registered Nurse
12497NP
OH
363LF0000X
Family Nurse Practitioner
Primary
APRN.CNP.12497
OH
363LF0000X
Family Nurse Practitioner
COA12497NP
OH
Other
Enumeration date
09/22/2011
Last updated
12/30/2020
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