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General NPI Number Information
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NPI Number | 1699326868
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Entity Type | Individual
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Provider Name | AMBER NICOLE CLARK
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Gender | Female
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Dates
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Enumeration Date | 09/27/2019
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Last Update Date | 09/27/2019
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Provider Practice Location Address
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Address Line | 2000 OLATHE BLVD MS 2028
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City | KANSAS CITY
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State | KS
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Zip | 66160
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Country | US
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Telephone | 913-588-6200
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Fax |
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Provider Business Mailing Address
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Address Line | 3901 RAINBOW BLVD # MS 2028
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City | KANSAS CITY
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State | KS
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Zip | 66160-8500
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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 | 367A00000X
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Taxonomy Name | Advanced Practice Midwife
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License Number | 05-79011-102
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License Number State | KS
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