Individual
ALICIA CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
1625 MEDICAL CENTER PT STE 200, COLORADO SPRINGS, CO 80907-5748
(719) 960-0363
Mailing address
1625 MEDICAL CENTER PT STE 200, COLORADO SPRINGS, CO 80907-5748
(719) 960-0363
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
2015030545
MO
363LF0000X
Family Nurse Practitioner
53-76985-042
KS
363LF0000X
Family Nurse Practitioner
Primary
C-APN.0103064-C-NP
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
420030171
—
MO
Enumeration date
10/08/2015
Last updated
10/31/2024
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