| NPI | 1629530993 |
|---|---|
| Former Name | CANDICE JHEANELL CLARKE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LA2100X Nurse Practitioner Acute Care (Licence: TX AP137930) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: TX AP137930) |
| Enumeration Date | 2019-04-04 |
| Last Update Date | 2019-11-14 |