Individual
SUSAN D. CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
1700 CARGO CT, LOUISVILLE, KY 40299-1938
(502) 749-6764
Mailing address
1700 CARGO CT, LOUISVILLE, KY 40299-1938
(502) 749-6764
Taxonomy
Speciality
Code
Description
License number
State
163WA2000X
Administrator Registered Nurse
Primary
1034142
KY
Other
Enumeration date
02/26/2019
Last updated
02/26/2019
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