National Provider Identifier

Rachel L Clark, NP-C

Rachel L Clark, NP-C is listed in the NPPES registry with a primary specialty of Family Nurse Practitioner in Ithaca, NY and a listed phone number of (607) 255-5155.

NPI 1740518646Ithaca, NYFamily Nurse Practitioner

Profile Overview

NPI
1740518646
Provider Type
Individual
Primary Specialty
Family Nurse Practitioner
Enumeration Date
December 03, 2009
Last Updated
April 29, 2024

Practice Location

  • 110 Ho Plz
  • Ithaca, NY 14853-3102

Phone: (607) 255-5155

Specialties

  • Family Nurse Practitioner (363LF0000X)
  • Family Nurse Practitioner (363LF0000X)
Full Record
NPI
1740518646
Entity Type
Individual
Last Name
Clark
First Name
Rachel
Middle Name
L
Name Prefix
MS.
Credential
NP-C
Mailing Street Address
110 Ho Plz
Mailing City
Ithaca
Mailing State
NY
Mailing ZIP Code
14853-3102
Mailing Country
US
Mailing Phone
(607) 255-5155
Practice Street Address
110 Ho Plz
Practice City
Ithaca
Practice State
NY
Practice ZIP Code
14853-3102
Practice Country
US
Practice Phone
(607) 255-5155
Enumeration Date
December 03, 2009
Last Updated
April 29, 2024
Sex
Female
Sole Proprietor
No
Certification Date
April 29, 2024
updated_by_file
npidata_pfile_20050523-20260308.csv
Taxonomies
Family Nurse Practitioner (363LF0000X), Family Nurse Practitioner (363LF0000X)
Other Identifiers
COA.11193-NP (OH, Certified Nurse Practitioner), RN.355902-COA1 (OH, RN)