Individual provider · Type 1 NPI

Victoria Dene Clark

Adult Health Nurse Practitioner · Southfield, MI

NPI number 1417361502 Active

Practice location

24111 Southfield Rd
Southfield, MI 48075-2841

Fax (248) 557-8860

Mailing address

30760 Nelson Circle
Westland, MI 48186

Specialties and licenses

TaxonomyCodeLicense
Adult Health Nurse Practitioner Primary 363LA2200X4704276153 (MI)

Adult Health Nurse Practitioner: Definition to come...

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About NPI 1417361502

Victoria Dene Clark's National Provider Identifier is 1417361502, issued on Jun 17, 2014. The primary taxonomy on file is Adult Health Nurse Practitioner (363LA2200X), and the practice location is in Southfield, MI. The record was last updated on Nov 20, 2014.