Individual
ANN MARIE CLACK
Active
Individual
ANN MARIE CLACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
WHNP
Taxonomy
Speciality
Code
Description
License number
State
163WM0102X
Maternal Newborn Registered Nurse
RN122544
LA
363LW0102X
Women's Health Nurse Practitioner
Primary
214452
LA
Other
Enumeration date
07/07/2021
Last updated
10/06/2021
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