| NPI | 1164108106 |
|---|---|
| Former Name | CHIQUITTA MARION CLARKE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: MD F06231363) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: MD F06231363) |
| 363LF0000X Nurse Practitioner, Family (Licence: MD F06231363) | |
| 363L00000X Nurse Practitioner (Licence: MD F06231363) | |
| Enumeration Date | 2023-06-26 |
| Last Update Date | 2025-10-06 |