Individual
NANCY FOWLER CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
110 IRVING ST NW, SUITE 2A38, WASHINGTON, DC 20010-2976
(202) 877-0788
Mailing address
110 IRVING ST NW, SUITE 2A38, WASHINGTON, DC 20010-2976
(202) 877-0788
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
RN62921
DC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036601700
—
DC
05
—
407365700
—
MD
Enumeration date
06/14/2006
Last updated
06/08/2011
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