Clark, Kristin Elise

Clark, Kristin Elise is an individual health care provider with primary practice located at 14700 28Th Ave N Ste 20 , Plymouth MN 55447-4876. She recently has 2 registered licenses in different health care specialties including Student, Health Care / Student in an Organized Health Care Education/Training Program, Allopathic & Osteopathic Physicians / Anesthesiology. Allopathic & Osteopathic Physicians / Anesthesiology is her primary health care specialty. Clark, Kristin Elise can be contacted via phone (763) 559-3779.

Contact Information

Primary practice address
14700 28Th Ave N Ste 20 Plymouth MN 55447-4876
Phone: (763) 559-3779
Fax: (763) 450-3986
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Student, Health Care / Student in an Organized Health Care Education/Training Program 390200000X
Allopathic & Osteopathic Physicians / Anesthesiology 207L00000X 64496 Minnesota

Profile Details

NPI number 1164764585
LBN Legal business name Clark, Kristin Elise
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 24th, 2013
Last updated Sep 26th, 2018 - about 6 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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