Clark, Kristina M

Clark, Kristina M is an individual health care provider with primary practice located at 700 Mcclellan St , Schenectady NY 12304-1019. She recently has 2 registered licenses in different health care specialties including Nursing Service Providers / Registered Nurse, Physician Assistants & Advanced Practice Nursing Providers / Pediatrics. Physician Assistants & Advanced Practice Nursing Providers / Pediatrics is her primary health care specialty. Clark, Kristina M can be contacted via phone (518) 372-5637.

Contact Information

Primary practice address
700 Mcclellan St Schenectady NY 12304-1019
Phone: (518) 372-5637
Fax: (518) 372-1384
Website:
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Health care specialties

SpecialtyCodeLicense #State
Nursing Service Providers / Registered Nurse 163W00000X 501366 New York
Physician Assistants & Advanced Practice Nursing Providers / Pediatrics 363LP0200X 382310 New York

Profile Details

NPI number 1679836605
LBN Legal business name Clark, Kristina M
Credentials Nurse Practitioner (NP)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 25th, 2012
Last updated Jan 25th, 2018 - about 6 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1679836605 NPPES
New York MEDICAID 03494502
New York Other 120919000071

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