Individual
MR. NATHAN BLAINE CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
APRN
Contact information
Practice address
400 INDUSTRIAL ROAD, SUITE A, MURRAY, KY 42071
(270) 761-9355
(270) 761-9356
Mailing address
2004 MELROSE DR, MURRAY, KY 42071-4700
(270) 293-0443
(270) 761-9356
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
3006900
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3006900
ARNP LICENSE
KY
Enumeration date
04/08/2011
Last updated
02/18/2022
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