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Contact Information

GINA CLARK, APRN
4200 GARDINER VIEW AVE
LOUISVILLE, KY40213-1877
 Phone: 502-456-0494
 Fax: 502-456-0496
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Primary Care

363LP2300X 50 Nurse Practitioner
 

Gerontology

363LG0600X 50 Nurse Practitioner
 

Nurse Practitioner

363L00000X 50 Nurse Practitioner
Indicates primary specialty

NPI Profile & details for GINA CLARK · (Female)

NPI Number 1174912406
Status Active
Credentials APRN (Advanced Practice Registered Nurse)
Entity Individual
Enumeration date 01/09/2015
Last updated 08/16/2019 - About 7 years ago
Sole proprietor 1 No
Identifiers
  • KY License # 3008878
Hospital affiliation(s)
  • JEWISH HOSPITAL & ST MARY'S HEALTHCARE - (Acute Care)
    200 ABRAHAM FLEXNER WAY
    LOUISVILLE, KY 40202
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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