Individual
CAROLYN MARIE CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1 CHILDRENS PL, SAINT LOUIS, MO 63110-1002
(314) 486-5388
Mailing address
1 CHILDRENS PL, SAINT LOUIS, MO 63110-1002
(314) 486-5388
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
2024001854
MO
Other
Enumeration date
03/01/2024
Last updated
03/29/2024
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