Clark, Patricia

Clark, Patricia is an individual health care provider with primary practice located at 1255 Golfview Ave , Bartow FL 33830-6736. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health. Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health is her primary health care specialty. Clark, Patricia can be contacted via phone (863) 519-3750.

Contact Information

Primary practice address
1255 Golfview Ave Bartow FL 33830-6736
Phone: (863) 519-3750
Fax: (863) 519-3753
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X ARNP1843682 Florida
Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health 363LP0808X ARNP1843682 Florida

Profile Details

NPI number 1114119070
LBN Legal business name Clark, Patricia
Credentials ARNP
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 15th, 2007
Last updated Aug 15th, 2019 - 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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Identifiers

StateTypeNumberIssuer
All States NPI 1114119070 NPPES
Florida MEDICAID 309082501
Florida Other ARNP1843682

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