Individual
MICHELLE E. CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
104 W SENECA ST, RAVENNA, NE 68869-1363
(308) 452-3203
(308) 452-3794
Mailing address
104 W SENECA ST, RAVENNA, NE 68869-1363
(308) 452-3203
(308) 452-3794
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
112270
NE
Other
Enumeration date
08/02/2017
Last updated
09/27/2021
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