Individual
KELLY CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN-CNP
Contact information
Practice address
667 CONVERSE DR, CINCINNATI, OH 45240-3619
(513) 967-5315
Mailing address
667 CONVERSE DR, CINCINNATI, OH 45240-3619
(513) 967-5315
Taxonomy
Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
Primary
APRN-CNP.0029273
OH
Other
Enumeration date
08/02/2021
Last updated
08/17/2022
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