Individual provider · NPI-1

Keely Clark, RNFA

Registered Nurse, Registered Nurse First Assistant · Fort Worth, TX

NPI number1437717469
StatusActive
Last updated in NPPESJun 4, 2019

Details

NPI
1437717469
Entity type
Individual (NPI-1)
Name
Keely Clark
Credential
RNFA
Sex
Female
Sole proprietor
No
Enumeration date
Jun 4, 2019
Last updated
Jun 4, 2019

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
163WR0006X Registered Nurse, Registered Nurse First Assistant729115TXYes

Practice location

1500 Cooper St
Fort Worth, TX 76104-2710

Phone 682-885-6400

Mailing address

Po Box 733784
Dallas, TX 75373-3784

Phone 682-885-1860

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