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Individual

MS. BONNIE L CLARK

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
WHNP-BC

Contact information

Practice address
5 SILVER RDG, VEAZIE, ME 04401-7086
(207) 942-0824
(207) 942-0824
Mailing address
5 SILVER RDG, VEAZIE, ME 04401-7086
(207) 942-0824
(207) 942-0824

Taxonomy

Speciality
Code
Description
License number
State
363LW0102X
Women's Health Nurse Practitioner
Primary
CNP81695
ME

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
CNP81695
MAINE STATE BOARD OF NURSING
ME
01
RN18038
MAINE STATE BOARD OF NURSING
ME
Enumeration date
01/15/2007
Last updated
06/26/2013
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