Individual
JANELISE S CLARKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
NP661A
ID
363LP0200X
Pediatric Nurse Practitioner
Primary
NUR-APRN-LIC-125338
MT
Other
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
Enumeration date
11/07/2006
Last updated
05/18/2026
Update your record
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