Individual provider · Type 1 NPI

Donald Lee Clark Iii, FNP-BC

Family Nurse Practitioner · Granite City, IL

NPI number 1366090573 Active

Practice location

2100 Madison Ave
Granite City, IL 62040-4713

Mailing address

8308 Burlington Dr
Troy, IL 62294-4003

Specialties and licenses

TaxonomyCodeLicense
Family Nurse Practitioner Primary 363LF0000X209019719 (IL)

Family Nurse Practitioner: Definition to come...

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About NPI 1366090573

Donald Lee Clark Iii, FNP-BC's National Provider Identifier is 1366090573, issued on Aug 30, 2019. The primary taxonomy on file is Family Nurse Practitioner (363LF0000X), and the practice location is in Granite City, IL. The record was last updated on Aug 30, 2019.