Healthcare Provider Details

I. General information

NPI: 1942093174
Provider Name (Legal Business Name): BRITTANY ANNE CLARK PMHNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/28/2025
Last Update Date: 04/14/2026
Certification Date: 04/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

145 HIGHWAY 82 E
BELL BUCKLE TN
37020-4506
US

IV. Provider business mailing address

145 HIGHWAY 82 E
BELL BUCKLE TN
37020-4506
US

V. Phone/Fax

Practice location:
  • Phone: 270-331-1769
  • Fax:
Mailing address:
  • Phone: 270-331-1769
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number39109
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: