Individual
DAWN N CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
915 E 1ST ST, DULUTH, MN 55805-2107
(218) 249-5352
(218) 249-5534
Mailing address
915 E 1ST ST, DULUTH, MN 55805-2107
(218) 249-5352
(218) 249-5534
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
R 160436-6
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1093955445
—
MN
05
—
1093955445
—
WI
Enumeration date
02/25/2009
Last updated
12/18/2020
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