Individual
BRENDA JILL CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ARNP FAMILY NURSE PR
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
A-106433
IA
363LP2300X
Primary Care Nurse Practitioner
Primary
A106433
IA
Other
Enumeration date
01/20/2011
Last updated
06/22/2015
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