Individual provider · Type 1 NPI

Kelli Marie Clarke

Nurse Practitioner · Salt Lake City, UT

NPI number 1902749302 Active

Practice location

100 N Mario Capecchi Dr
Salt Lake City, UT 84113-1103

Call (801) 662-1000 Map

Mailing address

PO Box 30180
Salt Lake City, UT 84130-0180

Other practice locations

1111 E Brickyard Rd Apt 530, Salt Lake City, UT 84106-4443 · (801) 662-1000

Specialties and licenses

Taxonomy	Code	License
Pediatric Registered Nurse	163WP0200X	11129491-3102 (UT)
Nurse Practitioner Primary	363L00000X	11129491-4405 (UT)

Nurse Practitioner: (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance wit…

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About NPI 1902749302

Kelli Marie Clarke's National Provider Identifier is 1902749302, issued on Apr 10, 2026. The primary taxonomy on file is Nurse Practitioner (363L00000X), and the practice location is in Salt Lake City, UT. The record was last updated on Jul 20, 2026.