Clark, Crystal Dawn
Clark, Crystal Dawn is an sole proprietor health care provider with primary practice located at 28 B Miller Road , Wheelersburg OH 45694-8103. She recently has only one registered license in Nursing Service Providers / Licensed Practical Nurse, which is considered as her primary health care specialty. Clark, Crystal Dawn can be contacted via phone (740) 285-6493.Contact Information
Primary practice address
28 B Miller Road
Wheelersburg OH 45694-8103
Phone: (740) 285-6493
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Nursing Service Providers / Licensed Practical Nurse | 164W00000X | 142164 | Ohio |
Profile Details
| NPI number | 1942503198 |
|---|---|
| LBN Legal business name | Clark, Crystal Dawn |
| Credentials | Licensed Practical Nurse (LPN) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Dec 9th, 2010 |
| Last updated | Oct 13th, 2014 - about 10 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1942503198 | NPPES |
| Ohio | MEDICAID | 3146303 |
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