Individual provider · Type 1 NPI
Shana Marie Clark
Family Nurse Practitioner · Louisville, KY
NPI number
1710407218
Active
Practice location
6101 Terry Rd
Louisville, KY 40258-3027
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Family Nurse Practitioner Primary | 363LF0000X | 3011392 (KY) |
Family Nurse Practitioner: Definition to come...
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About NPI 1710407218
Shana Marie Clark's National Provider Identifier is 1710407218, issued on Jun 26, 2017. The primary taxonomy on file is Family Nurse Practitioner (363LF0000X), and the practice location is in Louisville, KY. The record was last updated on Jul 21, 2022.