Individual
KARA ANNE CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ACNP
Contact information
Practice address
11601 IRON BRIDGE RD, SUITE 207, CHESTER, VA 23831-1466
(804) 285-6880
(804) 706-1585
Mailing address
11601 IRON BRIDGE RD, SUITE 207, CHESTER, VA 23831-1466
(804) 285-6880
(804) 706-1585
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
0024167520
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1710147145
NPI
VA
01
—
C09633
GROUP PTAN
VA
Enumeration date
06/10/2008
Last updated
03/07/2011
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