Individual
AMANDA CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
525 METRO PL N STE 300, DUBLIN, OH 43017-5320
(855) 289-1722
Mailing address
204 E 3RD ST, MAYSVILLE, KY 41056-1206
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
1153972
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2910854
—
OH
Enumeration date
07/18/2025
Last updated
07/18/2025
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