Deirdra Clark, FNP (NP-C) is a
Nurse Practitioner - Family based in Tabb, Virginia. Deirdra Clark is licensed to practice in Virginia (license number 0024172570) and her current practice location is
5007 #2 Victory Blvd., Tabb, Virginia. She can be reached at her office (for appointments etc.) via phone at
(757) 234-7987.
NPI number for Deirdra Clark is 1215306774 and her current mailing address is 2620 Elm Hill Pike, Nashville, Tennessee. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1215306774.
Provider's Profile
Full Name | Deirdra Clark |
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Gender | Female |
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Speciality | Nurse Practitioner - Family |
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Location | 5007 #2 Victory Blvd., Tabb, Virginia |
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Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
NPI Data:
- NPI Number: 1215306774
- Provider Enumeration Date: 09/15/2015
- Last Update Date: 09/15/2015
Medical Identifiers
Medical identifiers for Deirdra Clark such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1215306774 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
363LF0000X | Nurse Practitioner - Family | 0024172570 (Virginia) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Deirdra Clark is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Deirdra Clark, FNP (NP-C) 2620 Elm Hill Pike, Nashville, TN 37214-3108 Ph: (615) 425-4200 | Deirdra Clark, FNP (NP-C) 5007 #2 Victory Blvd., Tabb, VA 23693-5606 Ph: (757) 234-7987 |
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