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Organization

K. CLARK FAMILY MEDICAL PLLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
KAILYNN CLARK NP (PROVIDER)
(480) 518-5251
Entity
Organization

Contact information

Practice address
19938 E CARRIAGE WAY, QUEEN CREEK, AZ 85142-4907
(480) 518-5251
Mailing address
19938 E CARRIAGE WAY, QUEEN CREEK, AZ 85142-4907
(480) 518-5251

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
363LP0808X
Psychiatric/Mental Health Nurse Practitioner

Other

Enumeration date
07/18/2023
Last updated
05/11/2024
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