Individual
MS. ROCHELLE CRYSTAL CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1707 JUDY WAY, EDGEWOOD, MD 21040-1832
(443) 453-6174
Mailing address
1707 JUDY WAY, EDGEWOOD, MD 21040-1832
(443) 453-6174
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
R218420
MD
Other
Enumeration date
12/01/2020
Last updated
12/02/2020
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