Individual
TACIE A CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
200 HAWKINS DR, IOWA CITY, IA 52242-1009
(319) 471-1517
Mailing address
200 HAWKINS DR, IOWA CITY, IA 52242-1009
(319) 471-1517
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
103376
IA
Other
Enumeration date
04/30/2013
Last updated
03/25/2025
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