Elizabeth Clark, PA-C
Physician Assistant in Louisville, KY. Individual provider (NPI-1).
NPI number1972337814
StatusActive
Last updated in NPPESSep 11, 2024
Details
- NPI
- 1972337814
- Entity type
- Individual (NPI-1)
- Name
- Elizabeth Clark
- Credential
- PA-C
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Aug 30, 2024
- Certification date
- Sep 11, 2024
- Last updated
- Sep 11, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363A00000X | Physician Assistant | TC034 | KY | Yes |
Practice location
200 E Chestnut St Ste 303Louisville, KY 40202-1831
Phone 502-629-5552
Mailing address
1536 Anna LnLouisville, KY 40216-5469
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