Individual provider · Type 1 NPI

Kelly Ann Clark

Family Nurse Practitioner · Bethany, MO

NPI number 1164062972 Active

Practice location

3202 Miller St
Bethany, MO 64424-2713

Fax (660) 425-6663

Specialties and licenses

TaxonomyCodeLicense
Family Nurse Practitioner Primary 363LF0000X2020000768 (MO)
Family Medicine Physician 207Q00000X2020000768 (MO)

Family Nurse Practitioner: Definition to come...

14 other providers at this address

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About NPI 1164062972

Kelly Ann Clark's National Provider Identifier is 1164062972, issued on Jan 9, 2020. The primary taxonomy on file is Family Nurse Practitioner (363LF0000X), and the practice location is in Bethany, MO. The record was last updated on Mar 18, 2021.