Individual
REGINA K CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CPNP
Contact information
Practice address
1200 N PHILLIPS AVE, SUITE 9500, OKLAHOMA CITY, OK 73104-4600
(405) 271-6549
(405) 271-7866
Mailing address
1122 NE 13TH ST, ORI 236, OKLAHOMA CITY, OK 73117-1039
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
R0070771
OK
Other
Enumeration date
01/15/2009
Last updated
01/18/2011
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