Individual
MS. ELIZABETH ANN CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RNC MSN NNP
Contact information
Practice address
1325 PENNSYLVANIA AVE, #740, FORT WORTH, TX 76104-2158
(817) 250-2892
Mailing address
1325 PENNSYLVANIA AVE, # 740, FT WORTH, TX 76104-2158
(817) 250-2892
Taxonomy
Speciality
Code
Description
License number
State
363LN0000X
Neonatal Nurse Practitioner
CNP-02165
NM
363LN0005X
Critical Care Neonatal Nurse Practitioner
Primary
505735
TX
Other
Enumeration date
04/20/2006
Last updated
07/03/2013
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