Individual
KAREN CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CAA
Contact information
Practice address
111 COLCHESTER AVE, FAHC-WP2, BURLINGTON, VT 05401-1473
(802) 847-2415
(802) 847-5324
Mailing address
111 COLCHESTER AVE, FAHC-WP2, BURLINGTON, VT 05401-1473
(802) 847-2415
(802) 847-5324
Taxonomy
Speciality
Code
Description
License number
State
367H00000X
Anesthesiologist Assistant
Primary
135-0000005
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1012091
—
VT
Enumeration date
06/14/2006
Last updated
07/08/2020
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