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NPI Code Detail

MEDICARE: BARBARA B CLARK CRNP

MEDICARE: BARBARA B CLARK CRNP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LF0000XFamily Nurse PractitionerR106549MD

General Provider Information

NPI Number : 1669459707
Entity Type Code : Individual
Provider Name (Legal Business Name) : BARBARA B CLARK CRNP
Provider Business Mailing Address
First Line : 1701 FOREST GLEN RD
Second Line :
City : SILVER SPRING
State : MD
Zip : 20910-1409
Country : US
Telephone Number : 301-681-3619
Fax Number :
Provider Business Practice Location Address
First Line : 9309 OLD GEORGETOWN RD
Second Line :
City : BETHESDA
State : MD
Zip : 20814-1620
Country : US
Telephone Number : 301-841-0835
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/29/2005
Last Update Date : 07/08/2007

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