Individual
SAMANTHA CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1355 W BRIERBROOK RD, GERMANTOWN, TN 38138-2208
(901) 390-2930
Mailing address
1375 W BRIERBROOK RD, GERMANTOWN, TN 38138-2208
(901) 390-2930
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
32815
TN
363L00000X
Nurse Practitioner
904503
MS
Other
Enumeration date
09/18/2020
Last updated
01/22/2025
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