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General NPI Number Information
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NPI Number | 1104970151
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Entity Type | Individual
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Provider Name | SHARON ROSE CLARK R.N.C.,C.N.M.
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Gender | Female
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Dates
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Enumeration Date | 01/23/2007
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 600 S LAKEVIEW ST STE. 202
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City | STURGIS
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State | MI
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Zip | 49091-2371
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Country | US
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Telephone | 269-659-0174
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Fax |
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Provider Business Mailing Address
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Address Line | 120 S FRANKLIN ST
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City | CENTREVILLE
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State | MI
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Zip | 49032-9656
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Country | US
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Telephone | 269-467-7063
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163WM0102X
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Taxonomy Name | Maternal Newborn Registered Nurse
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License Number | 4704092855
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 176B00000X
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Taxonomy Name | Midwife
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License Number | 4704092855
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License Number State | MI
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