Provider Demographics
NPI:1720899941
Name:CLARK, SHEENA (REGISTERED NURSE)
Entity type:Individual
Prefix:
First Name:SHEENA
Middle Name:
Last Name:CLARK
Suffix:
Gender:F
Credentials:REGISTERED NURSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PENNWEST CLARION
Mailing Address - Street 2:840 WOOD STREET
Mailing Address - City:CLARION
Mailing Address - State:PA
Mailing Address - Zip Code:16214
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:UPMC NORTHWEST ED
Practice Address - Street 2:100 FAIRFIELD DRIVE
Practice Address - City:SENECA
Practice Address - State:PA
Practice Address - Zip Code:16246
Practice Address - Country:US
Practice Address - Phone:814-677-1585
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-16
Last Update Date:2025-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN675547163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse