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NPI Code Detail

MEDICARE: SHELBY CLARK NP

MEDICARE: SHELBY CLARK NP
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
1363LA2100XAcute Care Nurse PractitionerAPRN.CNP.0039833OH
2363L00000XNurse Practitioner95018735CA

General Provider Information

NPI Number : 1447912456
Entity Type Code : Individual
Provider Name (Legal Business Name) : SHELBY CLARK NP
Provider Business Mailing Address
First Line : 8000 5 MILE RD STE 260
Second Line :
City : CINCINNATI
State : OH
Zip : 45230-4365
Country : US
Telephone Number : 513-924-8900
Fax Number : 513-924-8972
Provider Business Practice Location Address
First Line : 8000 5 MILE RD STE 260
Second Line :
City : CINCINNATI
State : OH
Zip : 45230-4365
Country : US
Telephone Number : 513-924-8900
Fax Number : 513-924-8972
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/06/2021
Last Update Date : 12/31/2025

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