Healthcare Provider Details

I. General information

NPI: 1316337744
Provider Name (Legal Business Name): SARAH KAY CLARK NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/23/2015
Last Update Date: 03/30/2026
Certification Date: 03/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1192 EDWARDS DRIVE
PLAINFIELD IN
46168
US

IV. Provider business mailing address

1192 EDWARDS DRIVE
PLAINFIELD IN
46168
US

V. Phone/Fax

Practice location:
  • Phone: 317-839-9833
  • Fax: 317-839-7549
Mailing address:
  • Phone: 317-839-9833
  • Fax: 317-839-7549

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number71005546A
License Number StateIN
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number28185518A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: