# BOWLING GREEN NEUROLOGY AND PRIMARY CARE LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1447844014
- **Authorized official:** ANGELA G CLARK APRN (PROVIDER)
- **Authorized official phone:** (270) 393-8418

## Contact information

- **Practice address:** 523 PARK ST, BOWLING GREEN, KY 42101-1765
- **Practice address phone:** (270) 393-8418
- **Practice address fax:** (270) 393-8440
- **Mailing address:** 523 PARK ST, BOWLING GREEN, KY 42101-1765
- **Mailing address phone:** (270) 393-8418
- **Mailing address fax:** (270) 393-8440

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363LP2300X | Primary Care Nurse Practitioner | — | NULL | Yes |
| 363LP2300X | Primary Care Nurse Practitioner | — | — | Yes |

## Other

- **Enumeration date:** 02/24/2021
- **Last updated:** 02/24/2021