Individual
KEYONDRA CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BSN RN
Contact information
Practice address
411 W 24TH AVE, CORDELE, GA 31015-3941
(229) 699-2020
Mailing address
102 CARSON DR, CORDELE, GA 31015-6776
(229) 699-2020
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
—
—
Other
Enumeration date
08/28/2024
Last updated
08/28/2024
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