National Provider Identifier

Stephanie Clark

Stephanie Clark is listed in the NPPES registry with a primary specialty of Licensed Practical Nurse in Rochester, NY and a listed phone number of (716) 208-4601.

NPI 1306486444Rochester, NYLicensed Practical Nurse

Profile Overview

NPI
1306486444
Provider Type
Individual
Primary Specialty
Licensed Practical Nurse
Enumeration Date
January 07, 2020
Last Updated
January 07, 2020

Practice Location

  • 636 Clay Ave Uppr
  • Rochester, NY 14613-1030

Phone: (716) 208-4601

Specialties

  • Licensed Practical Nurse (164W00000X)
Full Record
NPI
1306486444
Entity Type
Individual
Last Name
Clark
First Name
Stephanie
Mailing Street Address
636 Clay Ave Uppr
Mailing City
Rochester
Mailing State
NY
Mailing ZIP Code
14613-1030
Mailing Country
US
Mailing Phone
(716) 208-4601
Practice Street Address
636 Clay Ave Uppr
Practice City
Rochester
Practice State
NY
Practice ZIP Code
14613-1030
Practice Country
US
Practice Phone
(716) 208-4601
Enumeration Date
January 07, 2020
Last Updated
January 07, 2020
Sex
Female
Sole Proprietor
Yes
Certification Date
January 07, 2020
updated_by_file
npidata_pfile_20050523-20260308.csv
Taxonomies
Licensed Practical Nurse (164W00000X)