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General NPI Number Information
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NPI Number | 1578941738
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Entity Type | Individual
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Provider Name | MIESHIA STAPLES CLARK DNP
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Gender | Female
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Dates
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Enumeration Date | 05/08/2015
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Last Update Date | 04/08/2022
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Provider Practice Location Address
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Address Line | 18766 JOHN J WILLIAMS HWY STE 306
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City | REHOBOTH BEACH
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State | DE
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Zip | 19971-4417
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Country | US
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Telephone | 302-985-2520
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Fax |
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Provider Business Mailing Address
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Address Line | 2201 CARLTON LANE SUITE B
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City | REHOBOTH
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State | DE
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Zip | 19971
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Country | US
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Telephone | 770-314-2611
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Fax |
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | APRN002575
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License Number State | NV
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | RN209521
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License Number State | GA
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Taxonomy #3
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | LG-0001366
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License Number State | DE
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