| Doctor Name: | LISA F CLARK |
| NPI Number: | 1366689895 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | ARNP |
| License Number: | 2075P |
| Business Practice Address: | 261 Hospital Dr Barbourville, KY - 409067356 |
| Business Phone Number: | 6065463486 |
| Business Fax Number: | 6065462867 |
| Mailing Address: | 261 Hospital Dr, BARBOURVILLE |
| State: | KY |
| Postal Code: | 409067356 |
| Phone Number: | 6065463486 |
| Fax Number: | 6065462867 |
| NPI Enumeration Date: | 01/21/2009 |
| NPI Last Update Date: | 06/02/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 364SW0102X |
| License Number: | 2075P |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | KY |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Clinical Nurse Specialist |
| Taxonomy Specialization: | Women's Health |
| Taxonomy Definition: | |