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Individual

SHELLEY KELLER CLARK

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
AG-ACNP

Contact information

Practice address
2232 W 24TH ST, PANAMA CITY, FL 32405-2226
(850) 215-3024
Mailing address
708 BREAKFAST POINT BLVD, PANAMA CITY BEACH, FL 32407-2534
(850) 294-1282

Taxonomy

Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
ARNP9288435
FL
363LA2200X
Adult Health Nurse Practitioner
ARNP9288435
FL
363LG0600X
Gerontology Nurse Practitioner
ARNP9288435
FL

Other

Enumeration date
04/13/2017
Last updated
03/27/2025
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