Individual provider · Type 1 NPI

Ella Rose Clark

Student in an Organized Health Care Education/Training Program · Beavercreek, OH

NPI number 1013880335 Active

Practice location

3640 Colonel Glenn Hwy
Beavercreek, OH 45324-2029

Call (937) 775-3490 Map

Mailing address

92 Ceramic Dr
Columbus, OH 43214-3004

Specialties and licenses

TaxonomyCodeLicense
Student in an Organized Health Care Education/Training Program Primary 390200000XNone listed

Student in an Organized Health Care Education/Training Program: An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

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About NPI 1013880335

Ella Rose Clark's National Provider Identifier is 1013880335, issued on Sep 24, 2025. The primary taxonomy on file is Student in an Organized Health Care Education/Training Program (390200000X), and the practice location is in Beavercreek, OH. The record was last updated on Jan 14, 2026.