Individual provider · Type 1 NPI
Shalita Clark, CRNP
Psychiatric/Mental Health Nurse Practitioner · Bronx, NY
NPI number
1396214060
Active
Practice location
234 E 149th St
Bronx, NY 10451-5504
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | 402966V (NY) |
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | 1-147364 (AL) |
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | 95010591 (CA) |
| Psychiatric/Mental Health Nurse Practitioner Primary | 363LP0808X | CV2100304 (IN) |
Psychiatric/Mental Health Nurse Practitioner: Definition to come...
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About NPI 1396214060
Shalita Clark, CRNP's National Provider Identifier is 1396214060, issued on Nov 24, 2018. The primary taxonomy on file is Psychiatric/Mental Health Nurse Practitioner (363LP0808X), and the practice location is in Bronx, NY. The record was last updated on Apr 22, 2022.