Erin Clark, RN

Individual provider Active NPI Registered Nurse · Mankato, MN

NPI 1770952012 · NPPES record last updated Sep 16, 2015

Key facts

NPI
1770952012
Entity type
Individual (NPI type 1)
Primary specialty
Registered Nurse 163W00000X
License
219704-7 (MN)
Practice address
1961 Premier Dr Ste 340
Mankato, MN 56001-6839
Phone
(507) 345-8591
NPI assigned
Sep 16, 2015
Sex
Female
Sole proprietor
No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
219704-7MNMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Adara Home Health, Inc. Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 219704-7 MN Yes

Addresses

Primary practice location

1961 Premier Dr Ste 340
Mankato, MN 56001-6839

Mailing address

1961 Premier Dr #340
Mankato, MN 56001
Phone (507) 345-8591

Other providers in Mankato, MN

All providers in Mankato, MN · Registered Nurse in Minnesota

Sources for this page

Verify at the official NPI Registry.