Individual
MS. KENDALL CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
715 W OGEECHEE ST, SYLVANIA, GA 30467-8693
(912) 451-4100
(912) 451-4105
Mailing address
PO BOX 194, SYLVANIA, GA 30467-0194
(912) 451-4100
(912) 531-7465
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
RN209683
GA
Other
Enumeration date
02/05/2015
Last updated
03/01/2023
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