Individual
LORA L CLARKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
454 ENTERPRISE DR, ROYERSFORD, PA 19468-1200
(610) 495-3330
Mailing address
454 ENTERPRISE DR, ROYERSFORD, PA 19468-1200
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
SP010247
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
440771
MLHC MEDICARE AA #
PA
Enumeration date
08/25/2009
Last updated
10/03/2019
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