Individual
MARY THERESA MCGUIRE CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNP
Contact information
Practice address
150 EMERSON AVE E, WEST SAINT PAUL, MN 55118-2535
(651) 241-1800
Mailing address
5439 UPPER 147TH ST W, APPLE VALLEY, MN 55124-6665
(612) 730-8117
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
F1014276
MN
Other
Enumeration date
10/09/2014
Last updated
11/09/2020
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