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Individual
KACY CLINKENBEARD
Active
Individual
KACY CLINKENBEARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
4063
SC
363A00000X
Physician Assistant
TC962
KY
363AM0700X
Medical Physician Assistant
TC962
KY
363AS0400X
Surgical Physician Assistant
TC962
KY
Other
Enumeration date
05/15/2020
Last updated
10/06/2021
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