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General NPI Number Information
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NPI Number | 1679724744
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Entity Type | Individual
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Provider Name | NATARSHA LYNETTE CLARK FNP-BC
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Gender | Female
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Dates
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Enumeration Date | 10/07/2008
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Last Update Date | 11/06/2015
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Provider Practice Location Address
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Address Line | 6431 FANNIN ST MSB 2.138
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City | HOUSTON
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State | TX
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Zip | 77030-1501
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Country | US
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Telephone | 713-704-4866
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Fax | 713-704-4988
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Provider Business Mailing Address
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Address Line | 4934 HARBOR GLEN LN
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City | HOUSTON
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State | TX
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Zip | 77084-3686
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Country | US
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Telephone |
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Fax |
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 675822
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | AP117069
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License Number State | TX
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