Individual
KIT CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
80 HIGHLAND ST, LACONIA, NH 03246-3235
(603) 524-3211
Mailing address
PO BOX 1328, AUBURN, ME 04211-1328
(207) 784-9185
(207) 784-1594
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
047303
NH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
30340919
—
NH
Enumeration date
11/08/2006
Last updated
07/08/2007
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