Individual
MS. PATRICIA CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
1255 GOLFVIEW AVE, BARTOW, FL 33830-6736
(863) 519-3750
(863) 519-3753
Mailing address
PO BOX 1559, BARTOW, FL 33831-1559
(863) 519-0575
(863) 519-0728
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
ARNP1843682
FL
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
ARNP1843682
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
309082501
—
FL
01
—
ARNP1843682
LICENSE NUMBER
FL
Enumeration date
08/15/2007
Last updated
08/15/2019
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