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Individual

MRS. BEVERLY ANN CLARK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
APRN-CNP

Contact information

Practice address
1060 SW 4TH ST, MOORE, OK 73160-2494
(405) 378-5491
(405) 378-5492
Mailing address
1060 SW 4TH ST, MOORE, OK 73160-2494
(405) 378-5491
(405) 378-5492

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
205019
OK

Other

Enumeration date
08/27/2021
Last updated
01/25/2023
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