Individual
KIERA ELISE CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
144 MILLTOWN RD, SHILOH, NC 27974-6220
(301) 904-4377
Mailing address
144 MILLTOWN RD, SHILOH, NC 27974-6220
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
245136
NC
207RC0000X
Cardiovascular Disease Physician
5014172
NC
363LF0000X
Family Nurse Practitioner
Primary
5014172
NC
Other
Enumeration date
02/21/2021
Last updated
05/04/2026
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