Individual
TRACY A CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
21624 MIDLAND DR, SHAWNEE, KS 66218-9064
(913) 643-0075
(913) 643-0077
Mailing address
901 E 104TH ST, MS 400S, KANSAS CITY, MO 64131
(816) 502-8752
(816) 932-9670
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
45920
KS
Other
Enumeration date
08/15/2006
Last updated
01/04/2018
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