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1710407218
SHANA MARIE CLARK
LOUISVILLE, KY
NPI
1710407218
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363LF0000X Nurse Practitioner, Family
(Licence: KY 3011392)
Enumeration Date
2017-06-26
Last Update Date
2022-07-21
Business Address
SHANA MARIE CLARK
6101 TERRY RD
LOUISVILLE, KY 40258-3027
Phone number: 502-807-5943
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Mailing Address
SHANA MARIE CLARK
6101 TERRY RD
LOUISVILLE, KY 40258-3027
Phone number: 502-807-5943
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