Individual
PAMELA CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
10309 LEICESTER DR, YUKON, OK 73099-7811
(405) 324-5721
Mailing address
10309 LEICESTER DRIVE, YUKON, OK 73099
(405) 324-5721
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
R0033957
OK
Other
Enumeration date
02/12/2014
Last updated
02/12/2014
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