Individual
KRYSTAL ALESHA CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DNP APRN WHNP-BC
Contact information
Practice address
2820 NE 214TH ST STE 822, AVENTURA, FL 33180-1270
(305) 204-7994
Mailing address
2820 NE 214TH ST STE 822, AVENTURA, FL 33180-1270
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN9320285
FL
363LW0102X
Women's Health Nurse Practitioner
Primary
11020351
FL
Other
Enumeration date
11/06/2023
Last updated
11/06/2023
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