# JANELISE S CLARKE

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1275602633
- **Gender:** F
- **Credential:** NP

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363L00000X | Nurse Practitioner | NP661A | ID | — |
| 363LP0200X | Pediatric Nurse Practitioner | NUR-APRN-LIC-125338 | MT | Yes |

## Other

- **Enumeration date:** 11/07/2006
- **Last updated:** 05/18/2026

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 000010160650 | REGENCE | ID |
| 01 | — | 300936 | ALTIUS HEALTH PLANS | ID |
| 05 | — | 806937600 | — | ID |
| 01 | — | P00393459 | RAILROAD MEDICARE | ID |