Individual
MEGAN F CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1055 N CURTIS ROAD, BOISE, ID 83706
(208) 367-4096
Mailing address
3340 E GOLDSTONE DR, MERIDIAN, ID 83642
(208) 367-4096
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
59471
ID
Other
Enumeration date
10/09/2018
Last updated
06/17/2019
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