Clark, Kerry

Clark, Kerry is an individual health care provider with primary practice located at 4660 Kenmore Avenue, Suite 305 & 500 , Alexandria VA 22304-1306. She recently has 4 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Physician Assistants & Advanced Practice Nursing Providers / Gerontology, Physician Assistants & Advanced Practice Nursing Providers / Adult Health, Physician Assistants & Advanced Practice Nursing Providers / Primary Care. Physician Assistants & Advanced Practice Nursing Providers / Adult Health is her primary health care specialty. Clark, Kerry can be contacted via phone (703) 988-4683.

Contact Information

Primary practice address
4660 Kenmore Avenue, Suite 305 & 500 Alexandria VA 22304-1306
Phone: (703) 988-4683
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X RN1038780 District of Columbia
Physician Assistants & Advanced Practice Nursing Providers / Gerontology 363LG0600X 0024178999 Virginia
Physician Assistants & Advanced Practice Nursing Providers / Adult Health 363LA2200X 0024178999 Virginia
Physician Assistants & Advanced Practice Nursing Providers / Primary Care 363LP2300X 0024178999 Virginia

Profile Details

NPI number 1932575743
LBN Legal business name Clark, Kerry
Credentials AGNP-BC
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 15th, 2015
Last updated Mar 6th, 2024 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1932575743 NPPES
Virginia MEDICAID 1932575743
Virginia MEDICAID 30016021870002

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