Individual
MS. SHANNON JOAN CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AGNP RN
Contact information
Practice address
3700 BARRETT DR STE 200, RALEIGH, NC 27609-7172
(919) 231-3966
(919) 231-3912
Mailing address
3700 BARRETT DR STE 200, RALEIGH, NC 27609-7172
(919) 231-3966
(919) 231-3912
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
5006374
NC
Other
Enumeration date
08/12/2013
Last updated
02/12/2025
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