NPI 1053617589

Amie Melissa Clark, CRNA

Practitioner Certified Registered Nurse Anesthetist Ballwin, MO

Practice location

Address: 13515 Barrett Parkway Dr Suite 170, Ballwin, MO 63021-5870
Phone: (314) 775-2811
Mailing address: 3975 Wilmington Ave APT a, Saint Louis, MO 63116-3250

Registered specialties (3)

Certified Registered Nurse Anesthetist Primary

Physician Assistants & Advanced Practice Nursing Providers Taxonomy 367500000X Licence 2016017057 (MO)

Other Nurse Anesthetist, Certified Registered providers in Missouri →

Registered Nurse

Nursing Service Providers Taxonomy 163W00000X Licence 041.389801 (IL)

Other Registered Nurse providers in Missouri →

Certified Registered Nurse Anesthetist

Physician Assistants & Advanced Practice Nursing Providers Taxonomy 367500000X Licence 086232 (FL)

Registry record

NPI: 1053617589
Entity type: Individual
Sex (as registered): Female
NPI issued: 31 Jan 2011
Record last updated: 25 Apr 2017

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.