Individual
SUSANNE CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
3740 OCOEE PL NW STE 101, CLEVELAND, TN 37312-5635
(423) 339-7107
Mailing address
3740 OCOEE PL NW STE 101, CLEVELAND, TN 37312-5635
(423) 339-7107
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
35006
TN
Other
Enumeration date
10/30/2023
Last updated
06/28/2024
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