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Contact Information

ELISHA A CLARK, NP
1330 CLARK ST
CAMBRIDGE, OH43725-9614
 Phone: 740-421-9530
 Fax: 740-421-9531
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Family

363LF0000X 50 Nurse Practitioner
 

Wound Care

163WW0000X
Indicates primary specialty

NPI Profile & details for ELISHA A CLARK · (Female)

NPI Number 1750664108
Status Active
Credentials NP (Nurse Practitioner)
Entity Individual
Enumeration date 09/22/2011
Last updated 12/30/2020 - About 5 years ago
Sole proprietor 1 No
Identifiers
  • OH License # 12497NP
  • OH License # APRN.CNP.12497
  • OH License # COA12497NP
Hospital affiliation(s)
  • GENESIS HEALTHCARE SYSTEM - (Acute Care)
    2951 MAPLE AVENUE
    ZANESVILLE, OH 43701
  • SOUTHEASTERN OHIO REGIONAL MEDICAL CENTER - (Acute Care)
    1341 NORTH CLARK STREET
    CAMBRIDGE, OH 43725
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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