Clark, Joan Marie
Clark, Joan Marie is an individual health care provider with primary practice located at 6400 Clayton Rd Ste 302 , Saint Louis MO 63117-1850. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Adult Health, which is considered as her primary health care specialty. Clark, Joan Marie can be contacted via phone (314) 645-3370.Contact Information
Primary practice address
6400 Clayton Rd Ste 302
Saint Louis MO 63117-1850
Phone: (314) 645-3370
Fax: (314) 645-0576
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Adult Health | 363LA2200X | 2816742621 | Missouri |
Profile Details
| NPI number | 1710969498 |
|---|---|
| LBN Legal business name | Clark, Joan Marie |
| Credentials | Adult Nurse Practitioner (ANP) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Nov 17th, 2005 |
| Last updated | Oct 20th, 2020 - 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1710969498 | NPPES |
| Missouri | Other | 060065 | EXCLUSIVE CHOICE |
| Missouri | Other | 213137 | EXCLUSIVE CHOICE |
| Missouri | Other | 500005275 | EXCLUSIVE CHOICE |
| Missouri | MEDICAID | 428933303 | EXCLUSIVE CHOICE |
| Missouri | Other | 072280 | EXCLUSIVE CHOICE |
| Missouri | Other | 534842 | EXCLUSIVE CHOICE |
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