Dawn A Clark

Individual provider Active NPI Psychiatric/Mental Health Registered Nurse · Eaton, OH

NPI 1134424583 · NPPES record last updated Jan 17, 2011

Key facts

NPI
1134424583
Entity type
Individual (NPI type 1)
Primary specialty
Psychiatric/Mental Health Registered Nurse 163WP0808X
License
RN332515 (OH)
Practice address
2172A US Route 127 N
Eaton, OH 45320-9289
Phone
(937) 456-1915
Fax
(937) 456-2208
NPI assigned
Jan 17, 2011
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
RN332515OHMDPsychiatric/Mental Health Registered Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Registered Nurse 163WP0808X RN332515 OH Yes

Addresses

Primary practice location

2172A US Route 127 N
Eaton, OH 45320-9289

Mailing address

2172A US Route 127 N
Eaton, OH 45320-9289
Phone (937) 456-1915

Other providers in Eaton, OH

All providers in Eaton, OH · Psychiatric/Mental Health Registered Nurse in Ohio

Sources for this page

Verify at the official NPI Registry.