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1235866898
KIWANNA NISHAE CLARK
NASHVILLE, TN
NPI
1235866898
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363LF0000X Nurse Practitioner, Family
(Licence: TN 29323)
Enumeration Date
2022-08-04
Last Update Date
2022-08-04
Business Address
KIWANNA NISHAE CLARK FNP
426 21ST AVE S # 7608
NASHVILLE, TN 37203-2424
Phone number: 615-321-2590
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Mailing Address
KIWANNA NISHAE CLARK FNP
3920 PUCKETT CREEK XING APT 104
MURFREESBORO, TN 37128-4251
Phone number: 205-563-0766
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