Individual provider · Type 1 NPI
Deirdra Clark, FNP (NP-C)
Family Nurse Practitioner · Tabb, VA
NPI number
1215306774
Active
Practice location
5007 #2 Victory Blvd.
Tabb, VA 23693-5606
Mailing address
2620 Elm Hill Pike
Nashville, TN 37214-3108
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Family Nurse Practitioner Primary | 363LF0000X | 0024172570 (VA) |
Family Nurse Practitioner: Definition to come...
About NPI 1215306774
Deirdra Clark, FNP (NP-C)'s National Provider Identifier is 1215306774, issued on Sep 15, 2015. The primary taxonomy on file is Family Nurse Practitioner (363LF0000X), and the practice location is in Tabb, VA. The record was last updated on Sep 15, 2015.