Individual
ERIN NOELLE CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
495 SW RAMSEY AVE, GRANTS PASS, OR 97527-5681
(541) 476-6644
Mailing address
275 WESTWOOD DR, GRANTS PASS, OR 97527-7231
(541) 660-0169
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
202101839NP-PP
OR
Other
Enumeration date
02/26/2021
Last updated
02/26/2021
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