TABITHA RYNN CLARK CNP NPI 1124762695

NPI Information

  • NPI: 1124762695
  • Provider Name: TABITHA RYNN CLARK, CNP
  • Classification: Nurse Practitioner - 363LP2300X
  • Specialization: Primary Care
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 519 G ROAD
    ARTHURDALE, WV
    ZIP 26520
  • Phone: (304) 864-0884

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NPI Details

Tabitha Rynn Clark, CNP is a primary care nurse practitioner in Arthurdale, WV. Tabitha Rynn Clark, CNP NPI is 1124762695. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

519 G ROAD
ARTHURDALE, WV
ZIP 26520
Phone: (304) 864-0884

The NPI 1124762695 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 4/21/2022 and was last updated on 9/29/2022.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1363LP2300XNurse PractitionerPrimary Care112519WEST VIRGINIAYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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