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Individual

LAURIE BETH CLARK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CNP

Contact information

Practice address
17009 E CHEYENNE DR, INDEPENDENCE, MO 64056
(816) 337-2192
Mailing address
17009 E CHEYENNE DR, INDEPENDENCE, MO 64056-1516
(816) 337-2192

Taxonomy

Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
2019042366
MO

Other

Enumeration date
11/05/2019
Last updated
11/05/2019
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