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:
Health care specialties
| Specialty | Code | License # | 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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