Dr KELLY O'BRIAN CLARK is a male medical professional, specializing in Nurse Practitioner. He graduated in 1996.
LAPORTE COUNTY COMPREHENSIVE MENTAL HEALTH COUNCIL
7224 W 400
MICHIGAN CITY
IN
463602903
Tel: 2198794621
| Npi | 1811086903 |
| Pac Id | 0143416677 |
| Professional Enrollment Id | I20101123000995 |
| Last Name | CLARK |
| First Name | KELLY |
| Middle Name | O'BRIAN |
| Suffix | |
| Gender | M |
| Credential | |
| Medical School Name | OTHER |
| Graduation Year | 1996 |
| Primary Specialty | NURSE PRACTITIONER |
| Secondary Specialty 1 | |
| Secondary Specialty 2 | |
| Secondary Specialty 3 | |
| Secondary Specialty 4 | |
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| Organization Legal Name | LAPORTE COUNTY COMPREHENSIVE MENTAL HEALTH COUNCIL |
| Group Practice Pac Id | 3274703046 |
| Number Of Group Practice Members | 11 |
| Line 1 Street Address | 7224 W 400 |
| Line 2 Street Address | |
| Marker Of Address Line 2 Suppression | |
| City | MICHIGAN CITY |
| State | IN |
| Zip Code | 463602903 |
| Phone Number | 2198794621 |
| Hospital Affiliation Ccn 1 | 150006 |
| Hospital Affiliation Lbn 1 | LA PORTE HOSPITAL |
| Hospital Affiliation Ccn 2 | 150015 |
| Hospital Affiliation Lbn 2 | FRANCISCAN ST ANTHONY HEALTH - MICHIGAN CITY |
| Hospital Affiliation Ccn 3 | |
| Hospital Affiliation Lbn 3 | |
| Hospital Affiliation Ccn 4 | |
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| Hospital Affiliation Lbn 5 | |
| Professional Accepts Medicare Assignment | Y |
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