RAVEN CLARK

MARIETTA, GA
NPI1427776160
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy363L00000X Nurse Practitioner
(Licence: GA  RN259021)
Additional Taxonomies363LF0000X Nurse Practitioner, Family
(Licence: GA  RN259021)
Enumeration Date2022-08-18
Last Update Date2023-01-06
Business Address
RAVEN CLARK NP
100 PIEDMONT RD NE
MARIETTA, GA 30066-3636
Phone number: 770-795-9844
Mailing Address
RAVEN CLARK NP
100 PIEDMONT RD NE
MARIETTA, GA 30066-3636
Phone number: