Individual provider · Type 1 NPI

Cotenna D. Clark

Gerontology Nurse Practitioner · Atlanta, GA

NPI number 1801401112 Active

Practice location

57 Executive Park South NE
Atlanta, GA 30329-2288

Call (404) 712-6929 Map

Fax (404) 712-0278

Mailing address

1857 Cameo Ct
Tucker, GA 30084-7002

Specialties and licenses

TaxonomyCodeLicense
Gerontology Nurse Practitioner Primary 363LG0600XRN231376 (GA)
Adult Health Nurse Practitioner 363LA2200XRN231376 (GA)

Gerontology Nurse Practitioner: Definition to come...

4 other providers at this address

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About NPI 1801401112

Cotenna D. Clark's National Provider Identifier is 1801401112, issued on Sep 14, 2020. The primary taxonomy on file is Gerontology Nurse Practitioner (363LG0600X), and the practice location is in Atlanta, GA. The record was last updated on Dec 11, 2025.