Individual
JULIA CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
102 LAKESEDGE LN APT 303, STAFFORD, VA 22554-7509
(207) 233-6921
Mailing address
170 PROSPECT ST UNIT 6, PROVIDENCE, RI 02906-1422
(207) 233-6921
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
0024196548
VA
Other
Enumeration date
02/21/2026
Last updated
02/21/2026
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