Individual
KRISTINA CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
625 19TH ST S, JT 807, BIRMINGHAM, AL 35249-6810
(205) 934-4696
(205) 934-9118
Mailing address
PO BOX 55310, BIRMINGHAM, AL 35255-5310
(205) 934-4696
(205) 934-9118
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
1-116388
AL
363LG0600X
Gerontology Nurse Practitioner
1-116388
AL
Other
Enumeration date
07/24/2015
Last updated
07/24/2015
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