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General NPI Number Information
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NPI Number | 1851846596
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Entity Type | Individual
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Provider Name | KAMILA CLARK
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Gender | Female
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Dates
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Enumeration Date | 08/23/2016
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Last Update Date | 08/23/2016
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Provider Practice Location Address
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Address Line | 7171 S CHEROKEE TRL 2232
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City | AURORA
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State | CO
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Zip | 80016-2287
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Country | US
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Telephone | 818-429-1070
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Fax |
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Provider Business Mailing Address
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Address Line | 7171 S CHEROKEE TRL 2232
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City | AURORA
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State | CO
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Zip | 80016-2287
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Country | US
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Telephone | 818-429-1070
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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 | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 1640123
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License Number State | CO
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Taxonomy #2
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Taxonomy Code | 163WC0200X
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Taxonomy Name | Critical Care Medicine Registered Nurse
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License Number | 1001115067
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License Number State | CA
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