Individual
KRISTEN ANN CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
15 HOSPITAL CENTER BLVD STE 1, HILTON HEAD ISLAND, SC 29926-2760
(843) 689-9200
(843) 689-9200
Mailing address
15 HOSPITAL CENTER BLVD STE 1, HILTON HEAD ISLAND, SC 29926-2760
(843) 689-9200
(843) 689-9200
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
363AM0700X
Medical Physician Assistant
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MPA2748
SC LICENSE
SC
Enumeration date
06/07/2017
Last updated
07/21/2022
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