Clark, Wanda Lu

Clark, Wanda Lu is an individual health care provider with primary practice located at 3113 Ross St , Amarillo TX 79103-2700. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, which is considered as her primary health care specialty. Clark, Wanda Lu can be contacted via phone (806) 374-7341.

Contact Information

Primary practice address
3113 Ross St Amarillo TX 79103-2700
Phone: (806) 374-7341
Fax: (806) 322-0533
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X 509539 Texas

Profile Details

NPI number 1356340681
LBN Legal business name Clark, Wanda Lu
Credentials Family Nurse Practitioner (FNP)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 19th, 2005
Last updated Mar 24th, 2020 - about 4 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 1356340681 NPPES
Texas MEDICAID 142123201
Texas Other 85N188

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