MEDICARE: RACHEL NICHOLE CLARKE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	11019449	FL
2	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	NP9328617	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1003550328
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RACHEL NICHOLE CLARKE

Provider Business Mailing Address
First Line	:	1651 NW 119TH ST
Second Line	:
City	:	NORTH MIAMI
State	:	FL
Zip	:	33167-3119
Country	:	US
Telephone Number	:	954-440-6260
Fax Number	:	305-391-3025

Provider Business Practice Location Address
First Line	:	1651 NW 119TH ST
Second Line	:
City	:	NORTH MIAMI
State	:	FL
Zip	:	33167-3119
Country	:	US
Telephone Number	:	954-440-6260
Fax Number	:	305-391-3025

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/22/2022
Last Update Date	:	12/05/2025

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Directions to “ RACHEL NICHOLE CLARKE ” Practice Location

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