Julienne E Clark, PHARMD
Individual provider Active NPI Pharmacist · Mabelvale, AR
NPI 1780985473 · NPPES record last updated Nov 11, 2010
Key facts
- NPI
- 1780985473
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 10339 (AR)
- Practice address
- 13907 High Rd
Mabelvale, AR 72103-3212 - Phone
- (501) 455-1086
- NPI assigned
- Nov 11, 2010
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 10339 | AR | MD | Pharmacist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 10339 | AR | Yes |
Addresses
Primary practice location
13907 High Rd
Mabelvale, AR 72103-3212
Mailing address
4108 Old Oak Dr
Little Rock, AR 72212-1931
Phone (501) 673-4400
Other providers in Mabelvale, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 11, 2010. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.