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Individual
SHALITA CLARK
Active
Individual
SHALITA CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
1-147364
AL
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
402966V
NY
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
95010591
CA
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
CV2100304
IN
Other
Enumeration date
11/24/2018
Last updated
04/22/2022
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