Individual provider · Type 1 NPI
Shantera Clark, FNP-C
Family Nurse Practitioner · Statesboro, GA
NPI number
1962020057
Active
Practice location
630 Ogeechee Dr W
Statesboro, GA 30461-6753
Mailing address
PO Box 1964
Statesboro, GA 30459-1964
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Family Nurse Practitioner Primary | 363LF0000X | RN220889 (GA) |
Family Nurse Practitioner: Definition to come...
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About NPI 1962020057
Shantera Clark, FNP-C's National Provider Identifier is 1962020057, issued on Jul 6, 2020. The primary taxonomy on file is Family Nurse Practitioner (363LF0000X), and the practice location is in Statesboro, GA. The record was last updated on Aug 4, 2022.