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Individual

NIKKI J CLARK

Active
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Individual

NIKKI J CLARK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
FNP-BC

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
893588
MS
363LF0000X
Family Nurse Practitioner
Primary
1180324
TX
363LF0000X
Family Nurse Practitioner
893588
MS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
05436046
MS
05
1484259
ND
Enumeration date
03/10/2016
Last updated
03/04/2026
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