NPI Profile for GINA CLARK in LOUISVILLE, KY.
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Primary Care |
363LP2300X | 50 | Nurse Practitioner | |
Gerontology |
363LG0600X | 50 | Nurse Practitioner | |
Nurse Practitioner |
363L00000X | 50 | Nurse Practitioner |
| 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 |
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| Hospital affiliation(s) |
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GINA CLARK
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