Individual
CRYSTAL DAWN CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-BC
Contact information
Practice address
1409 HATCHER LN, COLUMBIA, TN 38401-3535
(931) 548-2100
(931) 614-0875
Mailing address
1409 HATCHER LN, COLUMBIA, TN 38401-3535
(931) 548-2100
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
36529
TN
363LF0000X
Family Nurse Practitioner
Primary
36529
TN
Other
Enumeration date
06/24/2024
Last updated
05/07/2026
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