Individual provider · Type 1 NPI
Channel Trenise Clark, PMHNP-BC
Psychiatric/Mental Health Nurse Practitioner · Lees Summit, MO
NPI number
1477374874
Active
Practice location
237 NW Kessler Dr Apt 307
Lees Summit, MO 64081-4173
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Registered Nurse | 163W00000X | 2004022119 (MO) |
| Psychiatric/Mental Health Nurse Practitioner Primary | 363LP0808X | 2024039915 (MO) |
Psychiatric/Mental Health Nurse Practitioner: Definition to come...
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About NPI 1477374874
Channel Trenise Clark, PMHNP-BC's National Provider Identifier is 1477374874, issued on Oct 18, 2024. The primary taxonomy on file is Psychiatric/Mental Health Nurse Practitioner (363LP0808X), and the practice location is in Lees Summit, MO. The record was last updated on Oct 18, 2024.