Organization
CAROLYN CLARK FNP LLC
Active
Other names
Tri-Lakes Family Care
Organization subpart
No
Provider details
NPI number
Authorized official
CAROLYN CLARK NP-C (OWNER)
(417) 332-3639
Entity
Organization
Contact information
Practice address
1232 BRANSON HILLS PKWY STE 106, BRANSON, MO 65616-4189
(417) 332-3639
(417) 332-3641
Mailing address
1232 BRANSON HILLS PKWY STE 106, BRANSON, MO 65616-4189
(417) 332-3639
(417) 332-3641
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
2013024407
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1679915664
NPI
MO
Enumeration date
06/09/2015
Last updated
06/09/2015
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