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General NPI Number Information
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NPI Number | 1598388407
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Entity Type | Individual
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Provider Name | ROLYN MUNAH CLARKE FNP-BC
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Gender | Female
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Dates
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Enumeration Date | 05/26/2020
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Last Update Date | 10/13/2025
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Provider Practice Location Address
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Address Line | 2240 E 53RD ST STE B1
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City | INDIANAPOLIS
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State | IN
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Zip | 46220-3479
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Country | US
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Telephone | 317-933-7047
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Fax | 317-667-1574
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Provider Business Mailing Address
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Address Line | PO BOX 746720
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City | ATLANTA
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State | GA
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Zip | 30374-6720
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Country | US
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Telephone | 312-733-9730
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Fax | 773-866-8014
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 71010262A
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License Number State | IN
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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 | RN241581
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License Number State | GA
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