Individual provider · Type 1 NPI
Heidi Clark, CPNP
Pediatric Nurse Practitioner · Washington, DC
NPI number
1124189196
Active
Practice location
111 Michigan Ave NW
Washington, DC 20010-2916
Mailing address
8106 Chester St
Takoma Park, MD 20912-7339
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Pediatric Nurse Practitioner Primary | 363LP0200X | RN960959 (DC) |
Pediatric Nurse Practitioner: Definition to come...
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About NPI 1124189196
Heidi Clark, CPNP's National Provider Identifier is 1124189196, issued on Dec 13, 2006. The primary taxonomy on file is Pediatric Nurse Practitioner (363LP0200X), and the practice location is in Washington, DC. The record was last updated on Oct 9, 2012.