# Practitioner-TreyvorClark - PACIO Sample Data Depot v0.1.0

* [**Table of Contents**](toc.md)
* [**Artifacts Summary**](artifacts.md)
* **Practitioner-TreyvorClark**

## Example Practitioner: Practitioner-TreyvorClark

version: 4; Last updated: 2024-09-20 19:03:21+0000

**identifier**: `http://example.org/fhir/MI-state-license`/4804283961

**active**: true

**name**: Treyvor Clark

**telecom**: ph: (555) 384-3029, [tclark@MotorCitySNF.com](mailto:tclark@MotorCitySNF.com)

**address**: 18051 Mack Ave, Detroit, MI 48224

**gender**: Male



## Resource Content

```json
{
  "resourceType" : "Practitioner",
  "id" : "Practitioner-TreyvorClark",
  "meta" : {
    "versionId" : "4",
    "lastUpdated" : "2024-09-20T19:03:21.000+00:00"
  },
  "identifier" : [{
    "system" : "http://example.org/fhir/MI-state-license",
    "value" : "4804283961"
  }],
  "active" : true,
  "name" : [{
    "text" : "Treyvor Clark",
    "family" : "Clark",
    "given" : ["Treyvor"]
  }],
  "telecom" : [{
    "system" : "phone",
    "value" : "(555) 384-3029"
  },
  {
    "system" : "email",
    "value" : "tclark@MotorCitySNF.com"
  }],
  "address" : [{
    "text" : "18051 Mack Ave, Detroit, MI 48224",
    "line" : ["18051 Mack Ave"],
    "city" : "Detroit",
    "state" : "MI",
    "postalCode" : "48224",
    "country" : "US"
  }],
  "gender" : "male"
}

```
