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NPI Code Detail

MEDICARE: MRS. BEVERLY SIMPLER CLARKE M.S.N., R.N., C.R.N.

MEDICARE: MRS. BEVERLY SIMPLER CLARKE M.S.N., R.N., C.R.N.
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
1363LF0000XFamily Nurse PractitionerR109133MD

General Provider Information

NPI Number : 1407941214
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. BEVERLY SIMPLER CLARKE M.S.N., R.N., C.R.N.
Provider Business Mailing Address
First Line : 29600 MORGNEC RD
Second Line :
City : MILLINGTON
State : MD
Zip : 21651-1220
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 100 BROWN ST
Second Line :
City : CHESTERTOWN
State : MD
Zip : 21620-1435
Country : US
Telephone Number : 410-778-1420
Fax Number : 410-778-7086
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/04/2006
Last Update Date : 12/04/2025

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