Individual
MRS. MELANIE JO CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSN, APRN
Contact information
Practice address
7926 PRESTON HIGHWAY, SUITE 106, LOUISVILLE, KY 40219-3848
(502) 964-4357
(502) 966-5948
Mailing address
PO BOX 776351, CHICAGO, IL 60677-6351
(502) 588-9490
(502) 272-5116
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
3006627
KY
363LW0102X
Women's Health Nurse Practitioner
3006627
KY
Other
Enumeration date
09/30/2011
Last updated
01/12/2021
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