SHELLEY KELLER CLARK AG-ACNP NPI 1376077636

NPI Information

NPI: 1376077636
Provider Name: SHELLEY KELLER CLARK, AG-ACNP
Classification: Nurse Practitioner - 363LA2100X
Entity Type: Individual

Specialization: Acute Care

Organization: HNI MEDICAL SERVICES OF FLORIDA, LLC

PECOS Registration: Yes

Address:
615 N BONITA AVE
PANAMA CITY, FL
ZIP 32401
Phone: (850) 294-1282
Get Directions

Shelley Keller Clark, AG-ACNP is an acute care nurse practitioner in Panama City, FL with 8 years of experience. Shelley Keller Clark, AG-ACNP NPI is 1376077636. 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:

615 N BONITA AVE
PANAMA CITY, FL
ZIP 32401-623
Phone: (850) 294-1282

The NPI 1376077636 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 4/13/2017 and was last updated on 8/24/2021.

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
1	363LA2100X	Nurse Practitioner	Acute Care	ARNP9288435	FLORIDA	Yes
2	363LA2200X	Nurse Practitioner	Adult Health	ARNP9288435	FLORIDA	No
3	363LG0600X	Nurse Practitioner	Gerontology	ARNP9288435	FLORIDA	No

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: 11/14/2023

NPI Synchronization or Removal

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