Individual
BRENT CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
FNP, NP-C
Contact information
Practice address
17101 SNOWMOBILE LN STE 114, EAGLE RIVER, AK 99577-7043
(907) 562-2211
Mailing address
2440 E TUDOR RD # 781, ANCHORAGE, AK 99507-1185
(907) 545-4531
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
122126
AK
Other
Enumeration date
06/08/2017
Last updated
01/08/2024
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