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1174182281
KATHLEEN A CLARK
WINSTON SALEM, NC
NPI
1174182281
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363L00000X Nurse Practitioner
(Licence: NC 5011854)
Enumeration Date
2019-06-12
Last Update Date
2019-06-12
Business Address
KATHLEEN A CLARK FNP
1365 WESTGATE CENTER DR STE G1
WINSTON SALEM, NC 27103-2980
Phone number: 336-659-6250
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Mailing Address
KATHLEEN A CLARK FNP
5602 ERIC SUSTAR LN
MONROE, NC 28110-6721
Phone number: 704-953-0287
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