Individual
DR. HEATHER MARIE NETTLES CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
190 KIMEL PARK DRIVE, VETERANS AFFAIRS WINSTON SALEM OUTPATIENT CLINIC, WINSTON SALEM, NC 27103
(336) 768-3296
Mailing address
7045 ORCHARD PATH DR, CLEMMONS, NC 27012-8222
(336) 655-7271
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
2012-00476
NC
Other
Enumeration date
06/24/2010
Last updated
07/18/2015
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