Kimberly Sue Clark, LPN
Licensed Practical Nurse in Geneva, OH. Individual provider (NPI-1).
NPI number1114996931
StatusActive
Last updated in NPPESMar 19, 2021
Details
- NPI
- 1114996931
- Entity type
- Individual (NPI-1)
- Name
- Mrs. Kimberly Sue Clark
- Credential
- LPN
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Mar 15, 2006
- Certification date
- Mar 19, 2021
- Last updated
- Mar 19, 2021
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 164W00000X | Licensed Practical Nurse | pn096694 | OH | Yes |
Practice location
523 Atkins Rd.Geneva, OH 44041
Phone 440-218-0392
Mailing address
523 Atkins Rd.Geneva, OH 44041
Phone 440-218-0392
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