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General NPI Number Information
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NPI Number | 1922544766
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Entity Type | Individual
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Provider Name | KELLY ALEXA CLARKE ARNP
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Gender | Female
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Dates
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Enumeration Date | 01/18/2017
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Last Update Date | 07/17/2025
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Provider Practice Location Address
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Address Line | 905 THUNDER RD STE 250
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City | ELIZABETH CITY
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State | NC
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Zip | 27909-7672
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Country | US
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Telephone | 252-331-2044
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Fax |
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Provider Business Mailing Address
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Address Line | 6350 CENTER DR STE 200
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City | NORFOLK
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State | VA
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Zip | 23502-4107
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Country | US
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Telephone | 757-905-5558
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Fax | 757-213-5762
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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 | 0024192849
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License Number State | VA
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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 | ARNP9349079
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 1-185490
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License Number State | AL
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Taxonomy #4
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 5021875
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License Number State | NC
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