Healthcare Provider Details

I. General information

NPI: 1366740979
Provider Name (Legal Business Name): NADINE A CLARKE NP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/06/2011
Last Update Date: 08/08/2026
Certification Date: 08/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2054 VISTA PARKWAY EMERALD VIEW 400
WEST PALM BEACH FL
33411
US

IV. Provider business mailing address

1601 BELVEDERE RD STE 300E
WEST PALM BEACH FL
33406-1554
US

V. Phone/Fax

Practice location:
  • Phone: 561-576-7879
  • Fax:
Mailing address:
  • Phone: 561-331-3577
  • Fax: 561-331-3778

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number9189895
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number9189895
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberARNP-9189895
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: