Individual
TAYLOR E CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
3401 N BROAD ST, PHILADELPHIA, PA 19140-5103
(215) 707-3040
Mailing address
3401 N BROAD ST, PHILADELPHIA, PA 19140-5103
(215) 707-3040
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
SP026127
PA
363LG0600X
Gerontology Nurse Practitioner
Primary
SP026127
PA
Other
Enumeration date
09/07/2017
Last updated
09/12/2025
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