Individual
LANYN CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
40 LADUE TER, SAINT LOUIS, MO 63124-2048
(314) 954-9958
Mailing address
40 LADUE TER, SAINT LOUIS, MO 63124-2048
(314) 954-9958
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
2015014622
MO
Other
Enumeration date
03/23/2016
Last updated
03/23/2016
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