Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Kristen Clark

Individual provider Family Nurse Practitioner · NPI 1124902309

Kristen Clark is a Nurse Practitioner in Okatie, South Carolina. Qualified in 2025, 1 year ago. Practices as a sole proprietor. Licensed in South Carolina.

Years since qualifying
1
Licensed in
SC
In the registry since
2025

Practice location Address checks out

122 Okatie Center Blvd N Ste 240
Okatie, SC 29909-3782
Phone: (843) 832-7925
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence 30794 (SC)

Record details

NPI number1124902309
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedAugust 1, 2025
Last updated in NPPESAugust 1, 2025
Certification dateAugust 1, 2025

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2025 (1 years in practice)
Accepts Medicare assignment Not indicated
Practice locations2 on file with Medicare

Other providers in Okatie