Organization
HAILEY A. CLARK FNP-C LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. HAILEY ANNE CLARK FNP-C (OWNER)
(208) 223-1049
Entity
Organization
Contact information
Practice address
814 PANCHERI DR, IDAHO FALLS, ID 83402-3344
(208) 223-1049
Mailing address
4060 DUANE ST, IDAHO FALLS, ID 83401-1846
(208) 223-1049
Taxonomy
Speciality
Code
Description
License number
State
261QH0100X
Health Service Clinic/Center
Primary
—
—
Other
Enumeration date
03/05/2021
Last updated
03/05/2021
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