Individual provider · Type 1 NPI
Telisha Niketia Clark
Family Nurse Practitioner · Fayetteville, GA
NPI number
1659281608
Active
Practice location
475 Hilo Rd
Fayetteville, GA 30215-2101
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Family Nurse Practitioner Primary | 363LF0000X | APRN-NP312405 (GA) |
Family Nurse Practitioner: Definition to come...
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About NPI 1659281608
Telisha Niketia Clark's National Provider Identifier is 1659281608, issued on Sep 10, 2026. The primary taxonomy on file is Family Nurse Practitioner (363LF0000X), and the practice location is in Fayetteville, GA. The record was last updated on Sep 10, 2026.