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Individual

SAMANTHA CLARK

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
APRN-BC

Contact information

Practice address
5956 TURKEY LAKE RD, ORLANDO, FL 32819-4218
(407) 830-0414
Mailing address
5956 TURKEY LAKE RD, ORLANDO, FL 32819-4218

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
APRN11001826
FL
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
APRN11001826
FL

Other

Enumeration date
07/25/2017
Last updated
02/21/2023
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