Kristyn Lyn Clark
Nurse Practitioner, Family in Louisville, KY. Individual provider (NPI-1).
NPI number1982193298
StatusActive
Last updated in NPPESApr 3, 2023
Details
- NPI
- 1982193298
- Entity type
- Individual (NPI-1)
- Name
- Kristyn Lyn Clark
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- May 2, 2018
- Certification date
- Apr 3, 2023
- Last updated
- Apr 3, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363LF0000X | Nurse Practitioner, Family | 3012305 | KY | Yes |
Practice location
2021 Hikes LnLouisville, KY 40218-4817
Phone 502-446-5555 · Fax 502-394-3673
Mailing address
Po Box 776351Chicago, IL 60677-6351
Phone 502-588-9490 · Fax 502-272-5116
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