Provider Demographics
NPI:1740771088
Name:MALARK, CLAIRE (APRN,CNP)
Entity Type:Individual
Prefix:
First Name:CLAIRE
Middle Name:
Last Name:MALARK
Suffix:
Gender:F
Credentials:APRN,CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9800 HEALTH CARE LN
Mailing Address - Street 2:
Mailing Address - City:MINNETONKA
Mailing Address - State:MN
Mailing Address - Zip Code:55343-4542
Mailing Address - Country:US
Mailing Address - Phone:612-358-7351
Mailing Address - Fax:612-879-9116
Practice Address - Street 1:9800 HEALTH CARE LN
Practice Address - Street 2:
Practice Address - City:MINNETONKA
Practice Address - State:MN
Practice Address - Zip Code:55343-4542
Practice Address - Country:US
Practice Address - Phone:612-358-7351
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-05-22
Last Update Date:2020-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN5845363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner