Individual
ELIZABETH LEONA CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
630 E RIVER ST, ELYRIA, OH 44035-5902
(440) 329-7500
Mailing address
22451 GORE ORPHANAGE RD, NEW LONDON, OH 44851-9602
(440) 309-7546
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
APRN.CNP.022580
OH
363LF0000X
Family Nurse Practitioner
Primary
341203
OH
Other
Enumeration date
03/28/2018
Last updated
03/28/2018
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