Individual
KIMBERLY CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1481 W 10TH ST, INDIANAPOLIS, IN 46202-2803
(317) 554-0000
Mailing address
8792 N WHITE TAIL TRL, MC CORDSVILLE, IN 46055-9307
(317) 335-1337
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
28159554A
IN
Other
Enumeration date
04/07/2011
Last updated
04/07/2011
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