Elise Diane Clark in Lima - Nurse Practitioner
Elise Diane Clark - NPI 1184619595
Elise Diane Clark is a Nurse Practitioner in Lima, Ohio. Elise Diane Clark practices all healthcare services and medical treatments related to Nurse Practitioner. The NPI Number for Elise Diane Clark is 1184619595. The last update date is 2021-03-29.
Elise Diane Clark's current location address is 2875 W Elm St, Lima, Ohio. You can contact this provider via phone number 4199917805 and fax number 4199917862. The mailing address for Elise Diane Clark is 2875 W Elm St, Lima, Ohio. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Elise Diane Clark |
|---|---|
| Address | 2875 W Elm St, Lima, Ohio |
| Phone Number | 4199917805 |
| Fax Number | 4199917862 |
| Sole Proprietor | N |
| Credentials | FNP BC |
NPI Number Detail
| NPI Number | 1184619595 |
|---|---|
| Provider Enumeration Date | 2005-09-13 |
| Last Updated Date | 2021-03-29 |
Provider Mailing Address Detail
| Address | 2875 W Elm St |
|---|---|
| City | Lima |
| State | Ohio (OH) |
| Post Code | 458052510 |
| Phone Number | 4199917805 |
| Fax Number | 4199917862 |
Provider's Primary Taxonomy Detail
| Speciality | Nurse Practitioner |
|---|---|
| Taxonomy | 363L00000X |
| Licence No | NP06689 |
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Definition: (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certifi |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 9934001 | OH | MEDICARE PTAN | |
| 2360252 | OH | -- | |
| 500023896 | OH | TRAVELERS/RAILROAD MEDICA |
Post Comment/ Review Below
What is the Elise Diane Clark's unique identification number?
The Elise Diane Clark has been assigned the NPI (National Provider Identifier) Number 1184619595 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code serves as a unique identifier for the organization.
Where is the Elise Diane Clark located?
The Elise Diane Clark is located at 2875 W Elm St, Lima, OH 458052510.
What is Elise Diane Clark's primary field of medical specialization, and what is the corresponding taxonomy classification code for this area of expertise?
The primary field of medical specialization for Elise Diane Clark is Nurse Practitioner, and the taxonomy classification code that categorizes this area of expertise is 363L00000X.
On what date did the Centers for Medicare & Medicaid Services issue the 1184619595 to Elise Diane Clark?
The Elise Diane Clark received its 1184619595 assignment from the Centers for Medicare & Medicaid Services on 2005-09-13.
As of what date were the Elise Diane Clark's details last updated?
The information pertaining to the Elise Diane Clark, including its address, specialty, and other details, was most recently updated on 2021-03-29.
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