Healthcare Provider Details

I. General information

NPI: 1053928572
Provider Name (Legal Business Name): BRITTNEY MICHELLE CLARK PMHNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/29/2020
Last Update Date: 05/03/2026
Certification Date: 05/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2101 E PARHAM RD STE 102
HENRICO VA
23228-2234
US

IV. Provider business mailing address

508 S INDEPENDENCE BLVD STE 200
VIRGINIA BEACH VA
23452-1178
US

V. Phone/Fax

Practice location:
  • Phone: 804-799-9292
  • Fax: 757-930-6464
Mailing address:
  • Phone: 757-490-6463
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number0024180172
License Number StateVA
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number0024180172
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: