Individual
MR. JOHN HENRY CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
5049 AVOCET LN, PENSACOLA, FL 32514-8082
(850) 494-7079
Mailing address
5049 AVOCET LN, PENSACOLA, FL 32514-8082
(850) 494-7079
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
1-097045
AL
367500000X
Certified Registered Nurse Anesthetist
690232
TX
367500000X
Certified Registered Nurse Anesthetist
R40669
CT
367500000X
Certified Registered Nurse Anesthetist
Primary
RN 3072412
FL
367500000X
Certified Registered Nurse Anesthetist
RN491358/NA2011
CA
Other
Enumeration date
06/22/2005
Last updated
11/24/2010
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