KELLY CLARK

Nurse Practitioner - Family

Active Individual
NPI: 1164062972

Practice Address

3202 MILLER ST
Bethany, MO 64424

Phone: (660) 425-3154

Specialties

Specialty Code Primary License
Nurse Practitioner - Family 363LF0000X Yes 2020000768 (MO)
Family Medicine 207Q00000X No 2020000768 (MO)

Frequently Asked Questions

NPI 1164062972 is the National Provider Identifier for KELLY CLARK, a Nurse Practitioner - Family provider located in Bethany, MO. This NPI was enumerated on January 9, 2020.
KELLY CLARK practices at 3202 MILLER ST, Bethany, MO 64424.

Quick Facts

NPI
1164062972
Type
Individual
Enumerated
Jan 9, 2020
Last Updated
Mar 18, 2021

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