Kim Michele Clark, RN
Registered Nurse in Corvallis, OR. Individual provider (NPI-1).
NPI number1760638290
StatusActive
Last updated in NPPESAug 15, 2008
Details
- NPI
- 1760638290
- Entity type
- Individual (NPI-1)
- Name
- Kim Michele Clark
- Credential
- RN
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Aug 15, 2008
- Last updated
- Aug 15, 2008
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 163W00000X | Registered Nurse | 095006090RN | OR | Yes |
| 172V00000X | Community Health Worker | – | – |
Practice location
6820 Nw Grandview DrCorvallis, OR 97330-2706
Phone 541-753-0708
Mailing address
6820 Nw Grandview DrCorvallis, OR 97330-2706
Phone 541-753-0708
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