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Individual

PONTRIS SAPP CLARK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NURSE PRACTITIONER

Contact information

Practice address
9900 BREN RD E, MINNETONKA, MN 55343-9664
(800) 561-0861
Mailing address
6308 TORREY PINES DR, N RICHLAND HILLS, TX 76180-0832
(817) 676-4011

Taxonomy

Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
465762
TX
363LA2200X
Adult Health Nurse Practitioner
Primary
A1007111
TX

Other

Enumeration date
11/05/2007
Last updated
09/16/2020
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