Individual
ALLISON CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5130 SOUTHPORT SUPPLY RD SE, SOUTHPORT, NC 28461-9261
(910) 269-2053
Mailing address
5130 SOUTHPORT SUPPLY RD SE, SOUTHPORT, NC 28461-9261
(910) 269-2053
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
SP020248
PA
363LF0000X
Family Nurse Practitioner
Primary
5022987
NC
Other
Enumeration date
04/29/2019
Last updated
04/15/2026
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