Krysta Ellen Clark, is a
Registered Nurse - Diabetes Educator based in Poland, Maine. Krysta Ellen Clark is licensed to practice in Maine (license number RN74374) and her current practice location is
364 Maine St, Poland, Maine. She can be reached at her office (for appointments etc.) via phone at
(207) 312-8987.
NPI number for Krysta Ellen Clark is 1487447736 and her current mailing address is 364 Maine St, Poland, Maine. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1487447736.
Provider's Profile
| Full Name | Krysta Ellen Clark |
|---|
| Gender | Female |
|---|
| Speciality | Registered Nurse - Diabetes Educator |
|---|
| Location | 364 Maine St, Poland, Maine |
|---|
| Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
NPI Data:
- NPI Number: 1487447736
- Provider Enumeration Date: 05/28/2025
- Last Update Date: 05/28/2025
Medical Identifiers
Medical identifiers for Krysta Ellen Clark such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
| 1487447736 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
| 163WD0400X | Registered Nurse - Diabetes Educator | RN74374 (Maine) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Krysta Ellen Clark is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
Krysta Ellen Clark, 364 Maine St, Poland, ME 04274-5109 Ph: (207) 312-8987 | Krysta Ellen Clark, 364 Maine St, Poland, ME 04274-5109 Ph: (207) 312-8987 |
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