Individual
REBECCA CLARKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5357 27TH ST S APT 201, FARGO, ND 58104-7156
(701) 630-5135
Mailing address
5357 27TH ST S APT 201, FARGO, ND 58104-7156
(701) 630-5135
Taxonomy
Speciality
Code
Description
License number
State
163WM0705X
Medical-Surgical Registered Nurse
Primary
200780
ND
Other
Enumeration date
12/17/2024
Last updated
12/17/2024
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