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Contact Information

KRYSTA E CLARK
364 MAINE ST
POLAND, ME04274-5109
 Phone: 207-312-8987
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Diabetes Educator

163WD0400X
Indicates primary specialty

NPI Profile & details for KRYSTA E CLARK · (Female)

NPI Number 1487447736
Status Active
Credentials
Entity Individual
Enumeration date 05/28/2025
Last updated 05/28/2025 - More than a year ago
Sole proprietor 1 Yes
Identifiers
  • ME License # RN74374
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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