Individual
AMY WILSON CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1718 E 4TH ST, SUITE 601, CHARLOTTE, NC 28204-3261
(704) 384-1246
(704) 384-1249
Mailing address
PO BOX 60447, CHARLOTTE, NC 28260-0447
(704) 384-7840
(704) 384-7830
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
950019
NC
Other
Enumeration date
11/08/2006
Last updated
01/27/2009
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