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General NPI Number Information
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NPI Number | 1447912456
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Entity Type | Individual
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Provider Name | SHELBY CLARK NP
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Gender | Female
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Dates
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Enumeration Date | 10/06/2021
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Last Update Date | 12/31/2025
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Provider Practice Location Address
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Address Line | 8000 5 MILE RD STE 260
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City | CINCINNATI
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State | OH
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Zip | 45230-4365
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Country | US
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Telephone | 513-924-8900
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Fax | 513-924-8972
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Provider Business Mailing Address
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Address Line | 8000 5 MILE RD STE 260
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City | CINCINNATI
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State | OH
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Zip | 45230-4365
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Country | US
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Telephone | 513-924-8900
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Fax | 513-924-8972
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number | APRN.CNP.0039833
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 95018735
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License Number State | CA
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