National Provider Identifier Database

GINA CLARK, APRN – NPI #1174912406
Primary Care


Contact Information

GINA CLARK, APRN
4200 GARDINER VIEW AVE
LOUISVILLE, KY40213-1877
Phone: 502-456-0494
Fax: 502-456-0496
Website:
Specialty Taxonomy Code
* Primary Care 363LP2300X
Gerontology 363LG0600X
Nurse Practitioner 363L00000X

* Indicates primary specialty

NPI Profile & details for GINA CLARK

NPI Number 1174912406
Credentials APRN (Advanced Practice Registered Nurse)
Entity Individual
Enumeration date 01/09/2015
Last updated 08/16/2019 - About 7 years ago
Sole proprietor1 No
Identifiers
  • KY License #: 3008878
Hospital affiliation n/a

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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