Individual
PAULA FAE CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
1555 N 17TH AVE, GREELEY, CO 80631-9117
(970) 304-6425
(970) 304-6416
Mailing address
2930 11TH AVE, EVANS, CO 80620-1011
(970) 350-4606
(970) 350-4692
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
991016
CO
363LF0000X
Family Nurse Practitioner
76276
KS
Other
Enumeration date
02/26/2014
Last updated
11/16/2016
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