Individual
REBECCA KLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3737 SOUTHERN BLVD STE 3000A, KETTERING, OH 45429-1262
(937) 433-2051
Mailing address
8972 WILMINGTON RD, OREGONIA, OH 45054-9439
(937) 207-6932
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
APRN.CNP.0038871
OH
Other
Enumeration date
03/14/2025
Last updated
10/03/2025
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