Individual
CYNTHIA JILL MARTIN CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
2160 W ELM ST, WRIGHTSVILLE, GA 31096-2014
(478) 864-3446
(478) 864-1288
Mailing address
667 S MAIN ST, SWAINSBORO, GA 30401-4818
(478) 237-7798
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
RN129251
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
RN129251
GEORGIA LICENSE
GA
Enumeration date
08/31/2015
Last updated
07/20/2023
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