Individual
CAITLIN E CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
9100 W 74TH ST, SHAWNEE MISSION, KS 66204-4004
(913) 632-2230
(913) 632-2297
Mailing address
PO BOX 411895, KANSAS CITY, MO 64141-1895
(913) 647-4100
(913) 258-2509
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
119760
KS
367500000X
Certified Registered Nurse Anesthetist
Primary
557656
KS
Other
Enumeration date
12/03/2018
Last updated
01/25/2019
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