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:
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Health care specialties

SpecialtyCodeLicense #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 8 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 1881726271 NPPES
Ohio MEDICAID 2716887

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