Clark, Kristen Nicole

Clark, Kristen Nicole is an individual health care provider with primary practice located at 2435 Village Green Pl , Champaign IL 61822-7676. She recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as her primary health care specialty. Clark, Kristen Nicole can be contacted via phone (800) 325-7706.

Contact Information

Primary practice address
2435 Village Green Pl Champaign IL 61822-7676
Phone: (800) 325-7706
Fax: (309) 829-8397
Website:
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Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X 046010447 Illinois

Profile Details

NPI number 1306134317
LBN Legal business name Clark, Kristen Nicole
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 12th, 2011
Last updated Aug 5th, 2011 - about 15 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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