Provider Demographics
NPI:1346567930
Name:LARK, WILLIAM PATRICK (ARNP)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:PATRICK
Last Name:LARK
Suffix:
Gender:M
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1289
Mailing Address - Street 2:TAMPA GENERAL HOSPITAL, EMPLOYEE HEALTH SERVICES
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33601-1289
Mailing Address - Country:US
Mailing Address - Phone:813-844-7649
Mailing Address - Fax:
Practice Address - Street 1:1 TAMPA GENERAL CIRCLE
Practice Address - Street 2:TAMPA GENERAL HOSPITAL, EMPLOYEE HEALTH SERVICES
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33606-3571
Practice Address - Country:US
Practice Address - Phone:813-844-7649
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-04-22
Last Update Date:2010-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1771092363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health