Clark, Shannon Denise
Clark, Shannon Denise is an sole proprietor health care provider with primary practice located at 2 Easton Oval Ste 450 , Columbus OH 43219-6035. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health, Nursing Service Related Providers / Attendant Care Provider. Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health is her primary health care specialty. Clark, Shannon Denise can be contacted via phone (614) 475-9500.Contact Information
Primary practice address
2 Easton Oval Ste 450
Columbus OH 43219-6035
Phone: (614) 475-9500
Fax: (614) 475-9821
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health | 363LP0808X | APRN.CNP.023853 | Ohio |
Nursing Service Related Providers / Attendant Care Provider | 3747A0650X | RN-253819 | Ohio |
Profile Details
NPI number | 1881726271 |
---|---|
LBN Legal business name | Clark, Shannon Denise |
Credentials | Certified Nurse Practitioner (CNP) |
Entity | Individual |
Sole proprietor 1 | Yes |
Enumeration date | Mar 12th, 2007 |
Last updated | Dec 11th, 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.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1881726271 | NPPES |
Ohio | MEDICAID | 2716887 |
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