National Provider Identifier

Mandy Clark, NP

Mandy Clark, NP is listed in the NPPES registry with a primary specialty of Nurse Practitioner in Elmira, NY and a listed phone number of (607) 737-4130.

NPI 1740616846Elmira, NYNurse Practitioner

Profile Overview

NPI
1740616846
Provider Type
Individual
Primary Specialty
Nurse Practitioner
Enumeration Date
September 20, 2013
Last Updated
September 29, 2021

Practice Location

  • 600 Roe Ave Ste 1A
  • Elmira, NY 14905-1676

Phone: (607) 737-4130

Mailing Address

  • 571 Saint Josephs Blvd Fl 2
  • Elmira, NY 14901-3230

Specialties

  • Nurse Practitioner (363L00000X)
  • Nurse Practitioner (363L00000X)
Full Record
NPI
1740616846
Entity Type
Individual
Last Name
Clark
First Name
Mandy
Name Prefix
Mrs.
Credential
NP
Provider Other Last Name
Steiner
Provider Other First Name
Mandy
Provider Other Credential Text
NP
Provider Other Last Name Type Code
1
Mailing Street Address
571 Saint Josephs Blvd Fl 2
Mailing City
Elmira
Mailing State
NY
Mailing ZIP Code
14901-3230
Mailing Country
US
Mailing Phone
(607) 271-2050
Mailing Fax
(607) 873-1244
Practice Street Address
600 Roe Ave Ste 1A
Practice City
Elmira
Practice State
NY
Practice ZIP Code
14905-1676
Practice Country
US
Practice Phone
(607) 737-4130
Practice Fax
(607) 737-4530
Enumeration Date
September 20, 2013
Last Updated
September 29, 2021
Sex
Female
Sole Proprietor
No
Certification Date
September 29, 2021
updated_by_file
npidata_pfile_20050523-20260308.csv
Taxonomies
Nurse Practitioner (363L00000X), Nurse Practitioner (363L00000X)
Other Identifiers
03802251 (NY)