Individual
MRS. CAITLIN RANDI CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
623 E FORT UNION BLVD STE 105, MIDVALE, UT 84047-5529
(801) 261-9490
Mailing address
1711 GRANT AVE, OGDEN, UT 84404-5730
(801) 643-8225
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
12591240-8900
UT
Other
Enumeration date
08/22/2025
Last updated
09/24/2025
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