Individual
MRS. MELISSA CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
3421 W 9TH ST, WATERLOO, IA 50702-5401
(319) 272-8200
Mailing address
3421 W 9TH ST, WATERLOO, IA 50702-5401
(319) 272-8200
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
A174388
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0074435
—
IA
Enumeration date
02/02/2008
Last updated
05/30/2023
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