person
Mary Ellen Clark, CFNP
Primary Care Nurse Practitioner in Mountain Home Afb, Idaho
NPI 1891031621

Mary Ellen Clark is a Primary Care Nurse Practitioner based in Albuquerque, ID and is specialized in Primary Care. Mary Ellen Clark practices in Mountain Home Afb, ID and has the professional credentials of CFNP. The NPI Number for Mary Ellen Clark is 1891031621 and holds a License No. CNP-02460 (Idaho).

The current practice location address for Mary Ellen Clark is 90 Hope Dr Bldg 6000, Mountain Home Afb, ID and can be reached out via phone at 208-828-7635.

Location: 90 Hope Dr Bldg 6000, Mountain Home Afb, ID, 87125-6666
person
Provider Profile Details
NPI Number
1891031621
Provider Name
Mary Ellen Clark
Credential
CFNP
Provider Entity Type
Individual
Gender
Female
Address
90 Hope Dr Bldg 6000, Mountain Home Afb, ID, 87125-6666
Phone Number
208-828-7635
Fax Number
Provider Enumeration Date
12/26/2012
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
90 Hope Dr Bldg 6000
City
State
Zip
83648-1062
Phone Number
208-828-7635
Fax Number
person
Provider Business Mailing Address Details
Address
90 Hope Dr Bldg 6000
City
State
Zip
83648-1062
Phone Number
208-828-7635
Fax Number
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
Family
Taxonomy
License No.
201250210NP (Oregon)
Definition
Definition to come...
person
Provider's Taxonomy Details 2
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
Primary Care
Taxonomy
License No.
CNP-02460 (New Mexico)
Definition
Definition to come...
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