Individual
MS. NANCY JEANNE CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PAC
Contact information
Practice address
500 SW RAMSEY AVE, GRANTS PASS, OR 97527-5554
(541) 472-7000
Mailing address
825 BENNETT AVE, MEDFORD, OR 97504-6715
(541) 779-5228
(541) 772-1533
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA150863
OR
363A00000X
Physician Assistant
PA17218
CA
Other
Enumeration date
07/19/2006
Last updated
05/04/2017
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