Clark, Beth E

Clark, Beth E is an individual health care provider with primary practice located at 2500 S Havana St , Aurora CO 80014-1618. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Medical, which is considered as her primary health care specialty. Clark, Beth E can be contacted via phone (303) 338-4545.

Contact Information

Primary practice address
2500 S Havana St Aurora CO 80014-1618
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Medical 363AM0700X 900 Colorado

Profile Details

NPI number 1194715672
LBN Legal business name Clark, Beth E
Credentials Physician Assistant (PA)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 25th, 2005
Last updated Jun 6th, 2022 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1194715672 NPPES
Colorado MEDICAID 07009004
Colorado Other P00368635

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