Individual
BETHANY KRISTIN CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
706 PARK SHADOW CT, BALDWIN PARK, CA 91706-3266
(626) 589-0481
Mailing address
706 PARK SHADOW CT, BALDWIN PARK, CA 91706-3266
(626) 589-0481
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
95026372
CA
Other
Enumeration date
08/22/2023
Last updated
08/22/2023
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