Brian Kelly Clark, CRNA
Nurse Anesthetist, Certified Registered in Hampton, VA. Individual provider (NPI-1).
NPI number1821059403
StatusActive
Last updated in NPPESMar 8, 2022
Details
- NPI
- 1821059403
- Entity type
- Individual (NPI-1)
- Name
- Brian Kelly Clark
- Credential
- CRNA
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Mar 31, 2006
- Certification date
- Feb 23, 2022
- Last updated
- Mar 8, 2022
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 367500000X | Nurse Anesthetist, Certified Registered | 0024165065 | VA | Yes |
Practice location
501 Medical DrHampton, VA 23666-6080
Phone 703-295-9360 · Fax 703-295-9369
Mailing address
Po Box 37090Baltimore, MD 21297-3090
Phone 703-295-9360 · Fax 703-295-9369
Other practice locations
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All 34 Certified Registered Nurse Anesthetist providers in Hampton · All 3,376 providers in Hampton
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