NPI 1164764585

Kristin Elise Clark, MD

Practitioner Anesthesiology Physician Plymouth, MN

Practice location

Address: 14700 28th Ave N STE 20, Plymouth, MN 55447-4876
Phone: (763) 559-3779
Fax: (763) 450-3986
Mailing address: PO Box 47159, Plymouth, MN 55447-0159

Registered specialties (2)

Anesthesiology Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 207L00000X Licence 64496 (MN)

Other Anesthesiology providers in Minnesota →

Student in an Organized Health Care Education/Training Program

Student, Health Care Taxonomy 390200000X

Other Student in an Organized Health Care Education/Training Program providers in Minnesota →

Registry record

NPI: 1164764585
Entity type: Individual
Sex (as registered): Female
NPI issued: 24 Mar 2013
Record last updated: 26 Sep 2018

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.