IndividualActive
Gina Clark, APRN
NPI 1174912406 · Primary Care Nurse Practitioner · Louisville, KY
Provider details
- NPI number
- 1174912406
- Entity type
- Individual
- Primary specialty
- Primary Care Nurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers
- Credential
- APRN
- Sex
- Female
- Sole proprietor
- No
- License
- 3008878 (KY)
Specialties & taxonomies
Physician Assistants & Advanced Practice Nursing Providers
Physician Assistants & Advanced Practice Nursing Providers
Physician Assistants & Advanced Practice Nursing Providers
Practice location
4200 Gardiner View Ave
Louisville, KY 40213-1877
Phone: (502) 456-0494
Fax: (502) 456-0496
Approximate (ZIP-level) locationGet directions
Mailing address
3120 Runnymede Rd
Louisville, KY 40222-6144
Registry dates
- Enumerated
- 2015-01-09
- Last updated
- 2019-08-16
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.