Gabriela Clark, FNP-C
Nurse Practitioner, Family in Roswell, GA. Individual provider (NPI-1).
NPI number1750169504
StatusActive
Last updated in NPPESSep 21, 2023
Details
- NPI
- 1750169504
- Entity type
- Individual (NPI-1)
- Name
- Gabriela Clark
- Credential
- FNP-C
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Sep 21, 2023
- Certification date
- Sep 21, 2023
- Last updated
- Sep 21, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363LF0000X | Nurse Practitioner, Family | RN294112 | GA | Yes |
| 363L00000X | Nurse Practitioner | RN294112 | GA |
Practice location
11050 Crabapple RoadBldg. A, Suite 104-B
Roswell, GA 30075
Phone 770-645-0017 · Fax 770-645-0224
Mailing address
11050 Crabapple RoadBldg. A, Suite 104-B
Roswell, GA 30075
Phone 770-645-0017 · Fax 770-645-0224
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