Individual
PAULA ANN CLARK
Active
Individual
PAULA ANN CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CRNA
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
556632
CA
367500000X
Certified Registered Nurse Anesthetist
Primary
3548
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1261768
CAQH
—
01
—
I9551971
AETNA
—
Enumeration date
12/10/2007
Last updated
09/26/2024
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