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1598778854
TRACY A CLARK
SHAWNEE, KS
NPI
1598778854
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363LF0000X Nurse Practitioner, Family
(Licence: KS 45920)
Enumeration Date
2006-08-15
Last Update Date
2018-01-04
Business Address
-- TRACY A CLARK ARNP
21624 MIDLAND DR
SHAWNEE, KS 66218-9064
Phone number: 913-643-0075
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Mailing Address
-- TRACY A CLARK ARNP
901 E 104TH ST MS 400S
KANSAS CITY, MO 64131
Phone number: 816-502-8752
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