NPI | 1760712897 |
---|---|
Former Name | JANICE FLAGET CLARK |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: KY 3006287) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: KY 3006287) |
363LF0000X Nurse Practitioner, Family (Licence: KY 3006287) | |
Enumeration Date | 2010-01-13 |
Last Update Date | 2023-07-21 |