Individual
DANI CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP-C
Contact information
Practice address
823 CAMPBELL HILL ST NW, MARIETTA, GA 30060-1144
(770) 425-0118
Mailing address
823 CAMPBELL HILL ST NW, MARIETTA, GA 30060-1144
(770) 425-0118
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
RN165065
GA
Other
Enumeration date
04/22/2019
Last updated
04/22/2019
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