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

Mrs. Grace Clark, AGPCNP-B

Individual provider Primary Care Nurse Practitioner · NPI 1780030734

Mrs. Grace Clark, AGPCNP-B is a Nurse Practitioner in Austell, Georgia. Qualified in 2015, 11 years ago. Practices with Wellstar Medical Group LLC, a 3,072-clinician group, accepts Medicare assignment and offers telehealth. Licensed in Georgia.

Years since qualifying
11
Licensed in
GA
In the registry since
2016
Specialties on file
2

Practice location Address checks out

3825 Medical Park Dr Ste 100
Austell, GA 30106-6831
Phone: (770) 948-5578
Show map & directions

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

Specialties & licences

Adult Health Nurse Practitioner (primary) Taxonomy 363LA2200X · Licence RN 243044 (GA)
Primary Care Nurse Practitioner Taxonomy 363LP2300X · Licence RN243044 (GA)

Record details

NPI number1780030734
Entity typeIndividual (Type 1)
GenderFemale
Credentials AGPCNP-B
Sole proprietorNo
NPI enumeratedMay 9, 2016
Last updated in NPPESJanuary 3, 2019
Mailing address3825 Medical Park Dr, Suite 100, Austell, GA 30106-6831

Medicare enrollment

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

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2015 (11 years in practice)
Group practice Wellstar Medical Group Llc — 3072 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations2 on file with Medicare

Other providers in Austell