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NPI 1336872464

NPI 1336872464 : AUSTIN WILLIAM CLARK DNP, APRN-NP : OMAHA, NE

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General NPI Number Information
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    NPI Number           |    1336872464
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    Entity Type          |    Individual 
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    Provider Name        |    AUSTIN WILLIAM CLARK DNP, APRN-NP
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    07/06/2022
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    Last Update Date     |    06/30/2025
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Provider Practice Location Address
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    Address Line         |    8901 W DODGE RD STE 250 
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    City                 |    OMAHA
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    State                |    NE
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    Zip                  |    68114-3300
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    Country              |    US
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    Telephone            |    402-354-2000
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    Fax                  |    402-354-8645
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Provider Business Mailing Address
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    Address Line         |    PO BOX 3755 
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    City                 |    OMAHA
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    State                |    NE
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    Zip                  |    68103-0755
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    Country              |    US
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    Telephone            |    402-354-2100
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    Fax                  |    402-354-2155
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    363L00000X
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    Taxonomy Name        |    Nurse Practitioner
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    License Number       |    114267
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    License Number State |    NE
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Taxonomy #2
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    Taxonomy Code        |    363LC0200X
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    Taxonomy Name        |    Critical Care Medicine Nurse Practitioner
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    License Number       |    114267
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    License Number State |    NE
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