Kelly Clark is a Nurse Practitioner based in Irmo, SC. Kelly Clark practices in Irmo, SC. The NPI Number for Kelly Clark is 1639840580 and holds a License No. (South Carolina).
The current practice location address for Kelly Clark is 11134 Broad River Rd Ste D, Irmo, SC and can be reached out via phone at 803-732-0920.
Location: 11134 Broad River Rd Ste D, Irmo, SC, 29063-7616
Provider Profile Details
NPI Number
1639840580
Provider Name
Kelly Clark
Credential
Provider Entity Type
Individual
Gender
Female
Address
11134 Broad River Rd Ste D, Irmo, SC, 29063-7616
Phone Number
803-732-0920
Fax Number
Provider Enumeration Date
09/21/2021
Last Update Date
03/10/2024
Provider Business Practice Location Address Details
Address
11134 Broad River Rd Ste D
City
State
Zip
29063-7616
Phone Number
803-732-0920
Fax Number
Provider Business Mailing Address Details
Address
11134 Broad River Rd Ste D
City
State
Zip
29063-7616
Phone Number
803-732-0920
Fax Number
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
-
Taxonomy
License No.
25865 (South Carolina)
Definition
(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.
Provider's Taxonomy Details 2
Type
Student, Health Care
Classification
Student in an Organized Health Care Education/Training Program
Speciality
-
Taxonomy
License No.
()
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
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