Provider Demographics
NPI:1811240021
Name:CLARK, NEELOFER BAIG (L AC RN, FNP-C)
Entity Type:Individual
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First Name:NEELOFER
Middle Name:BAIG
Last Name:CLARK
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Gender:F
Credentials:L AC RN, FNP-C
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Mailing Address - Street 1:2695 ROCKY MOUNTAIN AVE STE 150
Mailing Address - Street 2:
Mailing Address - City:LOVELAND
Mailing Address - State:CO
Mailing Address - Zip Code:80538-9071
Mailing Address - Country:US
Mailing Address - Phone:970-970-2421
Mailing Address - Fax:970-490-4156
Practice Address - Street 1:1025 PENNOCK PL STE 121
Practice Address - Street 2:
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80524-3250
Practice Address - Country:US
Practice Address - Phone:970-495-8980
Practice Address - Fax:970-495-8988
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-25
Last Update Date:2023-01-31
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CO164885163W00000X
CO1443171100000X
COAPN.0998347363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse
No171100000XOther Service ProvidersAcupuncturist