Individual
DAVID BENJAMIN CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DNP
Contact information
Practice address
1500 CURVE CREST BLVD W, STILLWATER, MN 55082-6040
(651) 439-1234
Mailing address
3024 FURNESS CT, MAPLEWOOD, MN 55109-1423
(612) 940-3132
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
6100
MN
363L00000X
Nurse Practitioner
8758
WI
363LF0000X
Family Nurse Practitioner
1854912
MN
Other
Enumeration date
09/10/2018
Last updated
04/04/2024
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