IndividualActive
Benjamin Clark, CRNA
NPI 1407150055 · Certified Registered Nurse Anesthetist · Elkhart, IN
Provider details
- NPI number
- 1407150055
- Entity type
- Individual
- Primary specialty
- Certified Registered Nurse AnesthetistPhysician Assistants & Advanced Practice Nursing Providers
- Credential
- CRNA
- Sex
- Male
- Sole proprietor
- No
- License
- 28193318A (IN)
Specialties & taxonomies
Physician Assistants & Advanced Practice Nursing Providers
Practice location
600 East Blvd
Elkhart, IN 46514-2483
Phone: (574) 523-3193
Approximate (ZIP-level) locationGet directions
Mailing address
14660 Carrigan Ct
Granger, IN 46530-4222
Registry dates
- Enumerated
- 2010-12-22
- Last updated
- 2010-12-22
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.