Individual
KALI JO CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
363 LAKEWOOD LANE, ST. PAUL, MN 55110-1608
(651) 303-8997
Mailing address
363 LAKEWOOD LN, SAINT PAUL, MN 55110-1608
(651) 303-8997
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
169039-30
WI
163W00000X
Registered Nurse
38828
MT
Other
Enumeration date
06/08/2012
Last updated
06/08/2012
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