Individual
AMY B CLARKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
BUILDING 29, BLACK COAL DRIVE, FT. WASHAKIE, WY 82514
(307) 335-5940
(307) 332-3949
Mailing address
PO BOX 128, FORT WASHAKIE, WY 82514-0128
(307) 332-6846
(307) 332-3949
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
15074
WY
Other
Enumeration date
01/28/2009
Last updated
02/02/2009
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