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1114520749
VALISA ANN CLARK
ELIZABETHTOWN, KY
NPI
1114520749
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Former Name
VALISA ANN CULVER
Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
363LF0000X Nurse Practitioner, Family
(Licence: KY 3015341)
Enumeration Date
2020-11-17
Last Update Date
2020-11-17
Business Address
VALISA ANN CLARK APRN
913 N DIXIE AVE
ELIZABETHTOWN, KY 42701-2503
Phone number: 270-706-5171
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Mailing Address
VALISA ANN CLARK APRN
913 N DIXIE AVE
ELIZABETHTOWN, KY 42701-2503
Phone number: 270-706-5171
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