Individual
CRYSTAL JOAN CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
11930 ARBOR ST STE 200, OMAHA, NE 68144-2998
(402) 697-1601
Mailing address
11930 ARBOR ST STE 200, OMAHA, NE 68144-2998
(402) 697-1601
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
111457
NE
363LA2200X
Adult Health Nurse Practitioner
111457
NE
Other
Enumeration date
04/24/2013
Last updated
04/24/2013
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