Individual
MRS. MICHELLE ALLISON CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
F.N.P.
Contact information
Practice address
413 GLENBROOK RD, 9, STAMFORD, CT 06906-2126
(973) 518-1601
Mailing address
413 GLENBROOK RD, 9, STAMFORD, CT 06906-2126
(973) 518-1601
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
340960
NY
Other
Enumeration date
10/16/2016
Last updated
10/16/2016
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