Individual
KATRINA RANSOM CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PMHNP
Contact information
Practice address
120 WALKER DR NW, MILLEDGEVILLE, GA 31061-9561
(475) 457-7820
Mailing address
120 WALKER DR NW, MILLEDGEVILLE, GA 31061-9561
(475) 457-7820
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
RN150492
GA
Other
Enumeration date
08/28/2020
Last updated
08/28/2020
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