Individual
MS. KATHLEEN MARIE CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSN FNP C
Contact information
Practice address
1250 BELLFLOWER BLVD, SHS, LONG BEACH, CA 90840-0201
(562) 985-5146
(562) 985-8404
Mailing address
3247 CHATWIN AVE, SHS, LONG BEACH, CA 90808
(562) 354-6083
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
16395
CA
Other
Enumeration date
12/12/2006
Last updated
07/08/2007
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