Individual
JENNIFER CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1 VETERANS DR, MINNEAPOLIS, MN 55417-2309
(701) 866-3633
Mailing address
5853 LOGAN AVE S, MINNEAPOLIS, MN 55419-2044
(701) 866-3633
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
R184963-9
MN
Other
Enumeration date
07/28/2010
Last updated
07/25/2014
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