Individual
AMY K CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
6580 JUDSON RD, LONGVIEW, TX 75605-7076
(800) 939-7440
(903) 663-3629
Mailing address
6580 JUDSON RD, LONGVIEW, TX 75605-7076
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
RN063977
LA
Other
Enumeration date
01/30/2012
Last updated
01/30/2012
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