Individual
TANA LEE CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
36640 HIGHWAY 270, WEWOKA, OK 74884-4021
(405) 257-6282
(405) 257-3344
Mailing address
36640 HIGHWAY 270, WEWOKA, OK 74884-4021
(405) 257-6282
(405) 257-3344
Taxonomy
Speciality
Code
Description
License number
State
163WC1500X
Community Health Registered Nurse
Primary
R0086445
OK
Other
Enumeration date
02/24/2023
Last updated
02/24/2023
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