Individual
MRS. CATHY CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNM
Contact information
Practice address
1140 CARTHAGE STREET, SANFORD, NC 27330
(919) 775-2304
(919) 775-4050
Mailing address
1140 CARTHAGE STREET, SANFORD, NC 27330
(919) 775-2304
(919) 775-4050
Taxonomy
Speciality
Code
Description
License number
State
367A00000X
Advanced Practice Midwife
Primary
081217
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
081217
RN LICENSE
NC
01
—
NC230
NC APPROVAL TO PRACTICE
NC
Enumeration date
01/23/2007
Last updated
04/26/2012
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