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Individual
MARY JANET CLARK
Active
Individual
MARY JANET CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
1279432
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
Y8814
BS PROV
FL
Enumeration date
07/28/2006
Last updated
07/08/2007
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