Individual provider · Type 1 NPI

Myrlita Shawn Clark, NP, C

Gerontology Nurse Practitioner · Philadelphia, PA

NPI number 1871729889 Active

Practice location

1999 W Hunting Park Ave
Philadelphia, PA 19140-2828

Call (215) 228-9300 Map

Fax (215) 228-9913

Mailing address

432 N 6th St
Philadelphia, PA 19123-4004

Specialties and licenses

TaxonomyCodeLicense
Gerontology Nurse Practitioner Primary 363LG0600XSPO10333 (PA)

Gerontology Nurse Practitioner: Definition to come...

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About NPI 1871729889

Myrlita Shawn Clark, NP, C's National Provider Identifier is 1871729889, issued on Jun 4, 2009. The primary taxonomy on file is Gerontology Nurse Practitioner (363LG0600X), and the practice location is in Philadelphia, PA. The record was last updated on Apr 19, 2016.