Kelly Clark
Kelly Clark is a Student in an Organized Health Care Education/Training Program in Irmo, South Carolina. Licensed in South Carolina. Registered with an NPI since 2021.
- Licensed in
- SC
- In the registry since
- 2021
- Specialties on file
- 2
Practice location Address checks out
11134 Broad River Rd Ste DIrmo, SC 29063-7616
Phone: (803) 732-0920
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Nurse Practitioner (primary) | Taxonomy 363L00000X · Licence 25865 (SC) |
|---|---|
| Student in an Organized Health Care Education/Training Program | Taxonomy 390200000X |
Record details
| NPI number | 1639840580 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Female |
| Sole proprietor | No |
| NPI enumerated | September 21, 2021 |
| Last updated in NPPES | March 7, 2022 |
| Certification date | March 7, 2022 |
| Mailing address | 11134 Broad River Rd Ste D, Irmo, SC 29063-7616 |
Other providers in Irmo
-
Miss. Mackenzie Anderson
100 Walden Heights Dr Apt 802, Irmo, SC 29063-7871 · (478) 696-6135
-
Lindsay Walton Blount, MD
7428 Broad River Rd, Irmo, SC 29063-9662 · (803) 732-0140
-
Samantha Alice Santos
501 Crawfish Ln, Irmo, SC 29063-7632 · (803) 447-9043
-
Dreher Shuler
205 River Creek Dr, Irmo, SC 29063 · (803) 767-5697