Individual
MRS. NANCY JEAN CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
IBCLC
Contact information
Practice address
7402 FLEMINGWOOD LN, SPRINGFIELD, VA 22153-1701
(703) 731-8843
Mailing address
7402 FLEMINGWOOD LN, SPRINGFIELD, VA 22153-1701
(703) 731-8843
Taxonomy
Speciality
Code
Description
License number
State
174N00000X
Lactation Consultant (Non-RN)
Primary
18910401
VA
Other
Enumeration date
09/03/2012
Last updated
09/03/2012
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