Individual
MS. CARA CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NURSE PRACTITIONER
Contact information
Practice address
1500 S MAIN ST, FORT WORTH, TX 76104
(817) 702-1166
Mailing address
200 W MAGNOLIA AVE STE 201, FORT WORTH, TX 76104-7657
(817) 702-2977
Taxonomy
Speciality
Code
Description
License number
State
363LN0000X
Neonatal Nurse Practitioner
Primary
AP136560
TX
363LN0000X
Neonatal Nurse Practitioner
AP30005548
WA
Other
Enumeration date
06/23/2006
Last updated
07/18/2019
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