IndividualActive
Andrea Clark, PNP- PC/AC
NPI 1295457364 · Pediatric Nurse Practitioner · Phoenix, AZ
Provider details
- NPI number
- 1295457364
- Entity type
- Individual
- Primary specialty
- Pediatric Nurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers
- Credential
- PNP- PC/AC
- Sex
- Female
- Sole proprietor
- No
- License
- 264063 (AZ)
Specialties & taxonomies
Physician Assistants & Advanced Practice Nursing Providers
Practice location
1919 E Thomas Rd
Phoenix, AZ 85016-7710
Phone: (602) 933-1900
Fax: (602) 933-1918
Approximate (ZIP-level) locationGet directions
Mailing address
2108 E Thomas Rd Ste 130
Phoenix, AZ 85016-0008
Registry dates
- Enumerated
- 2022-09-15
- Last updated
- 2024-06-21
- Certified
- 2024-06-21
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.