Individual
KATHY LETT CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
340 EXEMPLA CIR STE 400, LAFAYETTE, CO 80026-3384
(303) 550-0832
Mailing address
PO BOX 803, LAFAYETTE, CO 80026-0803
(303) 550-0832
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
1627811
CO
364SP2800X
Perioperative Clinical Nurse Specialist
Primary
1627811
CO
Other
Enumeration date
12/10/2024
Last updated
12/10/2024
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