Individual
GREGORY P CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
APN
Contact information
Practice address
4674 SNOW MESA DR STE 100, FORT COLLINS, CO 80528-8614
(970) 482-3712
Mailing address
2695 ROCKY MOUNTAIN AVE STE 150, LOVELAND, CO 80538-9071
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN.0130031
CO
363LF0000X
Family Nurse Practitioner
Primary
APN.0996672-NP
CO
Other
Enumeration date
06/08/2021
Last updated
03/28/2024
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