Individual
ANNIE CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
108 W TYLER AVE, WEST MEMPHIS, AR 72301-4221
(870) 732-1191
Mailing address
108 W TYLER AVE, WEST MEMPHIS, AR 72301-4221
(870) 732-1191
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
36624
TN
Other
Enumeration date
08/30/2024
Last updated
01/26/2025
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