Individual
DAPHNE ANN CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
1900 N HIGHWAY 27, WHITLEY CITY, KY 42653-4119
(606) 376-3326
(888) 960-2041
Mailing address
PO BOX 1080, BURKESVILLE, KY 42717-1080
(270) 858-6655
(270) 858-4607
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
3006424
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12090990
CAQH
—
05
—
7100111350
—
KY
Enumeration date
04/09/2010
Last updated
08/03/2023
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