National Provider Identifier
Minnie R Clark, NP
Minnie R Clark, NP is listed in the NPPES registry with a primary specialty of Adult Health Nurse Practitioner in Medina, NY and a listed phone number of (585) 798-2000.
Profile Overview
- NPI
- 1811581762
- Provider Type
- Individual
- Primary Specialty
- Adult Health Nurse Practitioner
- Enumeration Date
- February 22, 2021
- Last Updated
- February 22, 2021
Practice Location
- 200 Ohio St
- Medina, NY 14103-1063
Phone: (585) 798-2000
Mailing Address
- 1642 Blood RD
- Lyndonville, NY 14098-9606
Specialties
- Adult Health Nurse Practitioner (363LA2200X)
Full Record
- NPI
- 1811581762
- Entity Type
- Individual
- Last Name
- Clark
- First Name
- Minnie
- Middle Name
- R
- Credential
- NP
- Mailing Street Address
- 1642 Blood RD
- Mailing City
- Lyndonville
- Mailing State
- NY
- Mailing ZIP Code
- 14098-9606
- Mailing Country
- US
- Mailing Phone
- (585) 590-6431
- Practice Street Address
- 200 Ohio St
- Practice City
- Medina
- Practice State
- NY
- Practice ZIP Code
- 14103-1063
- Practice Country
- US
- Practice Phone
- (585) 798-2000
- Enumeration Date
- February 22, 2021
- Last Updated
- February 22, 2021
- Sex
- Female
- Sole Proprietor
- No
- Certification Date
- February 22, 2021
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Adult Health Nurse Practitioner (363LA2200X)