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Individual
MEGHAN CLACK
Active
Individual
MEGHAN CLACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
101.0119535
VT
363LA2200X
Adult Health Nurse Practitioner
AP131114
TX
363LG0600X
Gerontology Nurse Practitioner
AP131114
TX
Other
Enumeration date
06/15/2016
Last updated
03/29/2021
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