Individual
LAUREN D'ANN CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
105 S BRYANT AVE STE 101, EDMOND, OK 73034-6330
(405) 823-0094
Mailing address
3305 RED MAPLE LN, MOORE, OK 73170-1025
(405) 823-0094
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
R0100056
OK
Other
Enumeration date
04/08/2020
Last updated
12/29/2022
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