Individual
KIMBERLY SUE CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-BC
Contact information
Practice address
8881 M 119, HARBOR SPRINGS, MI 49740
(231) 347-5400
(231) 348-2515
Mailing address
8881 M 119, HARBOR SPRINGS, MI 49740-9586
(231) 347-5400
(231) 348-2515
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
4704254566
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4704254566
STATE OF MICHIGAN
MI
Enumeration date
03/08/2011
Last updated
12/01/2022
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