Individual
KRISTIE DAWN CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHARMD, CDE
Contact information
Practice address
10816 BLACK DOG LN STE 160, CHARLOTTE, NC 28214-1479
(704) 316-3970
(704) 316-3971
Mailing address
PO BOX 60447, CHARLOTTE, NC 28260-0447
Taxonomy
Speciality
Code
Description
License number
State
1835P0018X
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
Primary
0070-00413
NC
1835P0018X
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
17299
NC
Other
Enumeration date
07/24/2012
Last updated
01/16/2025
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