Individual
KATHERINE SUE CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
7700 US HIGHWAY 158, STOKESDALE, NC 27357-9346
(800) 226-8874
Mailing address
3791 S CRANBERRY BLVD, NORTH PORT, FL 34286-4310
(941) 266-3681
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
501887
NC
363LF0000X
Family Nurse Practitioner
APRN11023419
FL
363LF0000X
Family Nurse Practitioner
GAA-NP001335
GA
Other
Enumeration date
06/28/2023
Last updated
01/29/2024
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