Individual
MS. MYRLITA SHAWN CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP,C
Contact information
Practice address
1999 W HUNTING PARK AVE, PHILADELPHIA, PA 19140-2828
(215) 228-9300
(215) 228-9913
Mailing address
432 N 6TH ST, PHILADELPHIA, PA 19123-4004
(215) 925-2400
(215) 925-9162
Taxonomy
Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
Primary
SPO10333
PA
Other
Enumeration date
06/04/2009
Last updated
04/19/2016
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