Doctor Name: | MRS. KIMBERLY ANN CLARKE |
NPI Number: | 1174862452 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | ARNP |
License Number: | ARNP9296757 |
Business Practice Address: | 3771 Tampa Rd Oldsmar, FL - 346773004 |
Business Phone Number: | 8663892727 |
Business Fax Number: | |
Mailing Address: | 5139 S Nichol St, TAMPA |
State: | FL |
Postal Code: | 336114135 |
Phone Number: | 9048746576 |
Fax Number: | |
NPI Enumeration Date: | 02/06/2013 |
NPI Last Update Date: | 02/06/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | ARNP9296757 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | FL |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |