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Contact Information

NICOLE M CLARK, M.S. R.D.
2 CRESCENT PARK WEST
NUTRITION SERVICES
WARREN, PA16365
 Phone: 814-723-4973
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Dietitian, Registered

133V00000X 71 Registered Dietitian or Nutrition Professional
 

Dietary Manager

132700000X
Indicates primary specialty

NPI Profile & details for NICOLE M CLARK · (Female)

NPI # 1720312820
Status Active
Credentials M.S. R.D.
Entity Individual
Enumeration date 09/23/2009
Last updated 09/23/2009 - About 17 years ago
Sole proprietor 1 No
Identifiers
  • NY License # 1004345
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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