Individual
KERRY A CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
2 DUDLEY ST, STE 200, PROVIDENCE, RI 02905-3236
(401) 457-1540
Mailing address
PO BOX 1119, PROVIDENCE, RI 02901-1119
(401) 457-1540
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
APRN00233
RI
Other
Enumeration date
06/15/2006
Last updated
03/17/2022
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