Individual
MIRANDA CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
333 E COUNTY LINE RD STE B, GREENWOOD, IN 46143-1080
(317) 497-6371
Mailing address
6626 E 75TH ST STE 500, INDIANAPOLIS, IN 46250-2890
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
71012707A
IN
Other
Enumeration date
06/14/2022
Last updated
01/26/2024
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