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Individual

DR. AMY JO CLARK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
APNP

Contact information

Practice address
1621 N TAYLOR DR STE 100, SHEBOYGAN, WI 53081-1993
(920) 452-1650
(920) 452-3594
Mailing address
1621 N TAYLOR DR STE 100, SHEBOYGAN, WI 53081-1993
(920) 452-1650

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
161099-30
WI
363LF0000X
Family Nurse Practitioner
Primary
7806-33
WI

Other

Enumeration date
05/19/2017
Last updated
12/30/2021
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