Individual
DANIELLE ELIZABETH CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
1221 S BROADWAY, LEXINGTON, KY 40504-2701
(859) 258-4000
(859) 258-6203
Mailing address
1221 S BROADWAY, LEXINGTON, KY 40504-2701
(859) 258-6200
(859) 258-6203
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
3013722
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100622120
—
KY
Enumeration date
09/04/2019
Last updated
09/11/2024
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