Individual
LAUREN CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5800 WALNUT ST, PHILADELPHIA, PA 19139-3836
(267) 347-2073
Mailing address
PO BOX 974, BRYN MAWR, PA 19010-0974
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
SP028442
PA
Other
Enumeration date
10/11/2023
Last updated
10/24/2023
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