Individual
GINA K CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
990 WILKINSON TRCE STE 100, BOWLING GREEN, KY 42103-3404
(270) 781-4043
(270) 781-4196
Mailing address
201 PARK ST, BOWLING GREEN, KY 42101-1759
(270) 780-2497
(270) 783-3750
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
3003560
KY
363L00000X
Nurse Practitioner
3560P
KY
Other
Enumeration date
10/23/2006
Last updated
04/11/2015
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