IndividualActive
Stephen Clark, NURSE PRACTITIONER
NPI 1083039085 · Family Health Clinical Nurse Specialist · Philadelphia, PA
Provider details
- NPI number
- 1083039085
- Entity type
- Individual
- Primary specialty
- Family Health Clinical Nurse SpecialistPhysician Assistants & Advanced Practice Nursing Providers
- Credential
- NURSE PRACTITIONER
- Sex
- Male
- Sole proprietor
- Yes
- License
- SP013599 (PA)
Specialties & taxonomies
Physician Assistants & Advanced Practice Nursing Providers
Practice location
1013 E Haines St
Philadelphia, PA 19138-1533
Phone: (215) 438-1095
Approximate (ZIP-level) locationGet directions
Mailing address
1013 E Haines St
Philadelphia, PA 19138-1533
Registry dates
- Enumerated
- 2014-02-27
- Last updated
- 2014-02-27
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.