Individual
CHARLES NICHOLSON CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
FNP
Contact information
Practice address
575 HILL COUNTRY DR STE 301, KERRVILLE, TX 78028-6024
(830) 258-7762
Mailing address
575 HILL COUNTRY DR STE 101, KERRVILLE, TX 78028-6024
(830) 258-7762
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
AP139709
TX
Other
Enumeration date
11/12/2018
Last updated
08/22/2022
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