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Individual

HEATHER ANNE CLARK

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
AGANCP

Contact information

Practice address
300 PASTEUR DR, STANFORD, CA 94305-2200
(650) 723-6459
Mailing address
300 PASTEUR DR, STANFORD, CA 94305-2200

Taxonomy

Speciality
Code
Description
License number
State
282N00000X
General Acute Care Hospital
95001169
CA
363L00000X
Nurse Practitioner
Primary
95001169
CA
363LC0200X
Critical Care Medicine Nurse Practitioner
NP95001169
CA

Other

Enumeration date
09/23/2014
Last updated
10/07/2015
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