Individual provider · Type 1 NPI

Theresa Ann Clark, FNP-BC

Family Nurse Practitioner · Elkhart, IN

NPI number 1548893506 Active

Practice location

22818 Old US 20
Elkhart, IN 46516-9150

Mailing address

69014 Tamarack Rd
Walkerton, IN 46574-9735

Specialties and licenses

TaxonomyCodeLicense
Family Nurse Practitioner Primary 363LF0000X71010178A (IN)

Family Nurse Practitioner: Definition to come...

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About NPI 1548893506

Theresa Ann Clark, FNP-BC's National Provider Identifier is 1548893506, issued on Feb 18, 2020. The primary taxonomy on file is Family Nurse Practitioner (363LF0000X), and the practice location is in Elkhart, IN. The record was last updated on Dec 12, 2025.