Individual
MS. AMIE S CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
A.P.R.N.
Contact information
Practice address
50 N MEDICAL DR, SALT LAKE CITY, UT 84132-0001
(801) 581-2121
Mailing address
PO BOX 581700, SALT LAKE CITY, UT 84158-1700
(801) 213-3800
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
5125361-4405
UT
Other
Enumeration date
11/28/2006
Last updated
07/08/2007
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