Individual
HALEY MICHELLE CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
16216 BAXTER RD STE 100, CHESTERFIELD, MO 63017-4778
(636) 449-4700
(636) 449-2595
Mailing address
7757 MISSY CT, SAINT LOUIS, MO 63123-1930
(314) 677-4994
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
2023035149
MO
Other
Enumeration date
09/12/2023
Last updated
11/19/2024
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