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Mrs. Lisa L. Clark, FNP
Family Nurse Practitioner in Gray, Georgia
NPI 1801160353

Lisa L. Clark is a Family Nurse Practitioner based in Gray, GA and is specialized in Family. Lisa L. Clark practices in Gray, GA and has the professional credentials of FNP. The NPI Number for Lisa L. Clark is 1801160353 and holds a License No. RN089162 (Georgia).

The current practice location address for Lisa L. Clark is 1005 Boulder Dr, Gray, GA and can be reached out via phone at 478-621-2100 and via fax at 478-744-0481.

Location: 1005 Boulder Dr, Gray, GA, 31032-6141
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1801160353
Provider Name
Lisa L. Clark
Credential
FNP
Provider Entity Type
Individual
Gender
Female
Address
1005 Boulder Dr, Gray, GA, 31032-6141
Phone Number
478-621-2100
Fax Number
478-744-0481
Provider Enumeration Date
03/01/2012
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
003179288A 05 GA
institution
Provider Business Practice Location Address Details
Address
1005 Boulder Dr
City
Gray
State
Georgia
Zip
31032
Phone Number
478-621-2100
Fax Number
478-744-0481
person
Provider Business Mailing Address Details
Address
1005 Boulder Dr
City
Gray
State
Georgia
Zip
31032
Phone Number
478-621-2100
Fax Number
478-744-0481
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
Family
Taxonomy
363LF0000X
License No.
RN089162 (Georgia)
Definition
Definition to come...
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