LAUREN WILSON CLARK CRNP-AC
NPI 1063173557
Nurse Practitioner - Pediatrics in Philadelphia, PA
About Lauren Wilson Clark Crnp-ac NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
LAUREN WILSON CLARK CRNP-AC (NPI 1063173557) is an individual pediatrics provider in Philadelphia, Pennsylvania, licensed in Pennsylvania (SP025013) and active in the NPI registry since January 2022. She is enrolled in Medicare PECOS.
NPPES Registry Identity
Specialties & Licenses
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Lauren Wilson Clark Crnp-ac is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 19104 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Other Providers at the Same Location NPPES 20
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
PHILADELPHIA, PA 19104
PHILADELPHIA, PA 19104
PHILADELPHIA, PA 19104
PHILADELPHIA, PA 19104
PHILADELPHIA, PA 19104
PHILADELPHIA, PA 19104
PHILADELPHIA, PA 19104
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Lauren Clark's NPI number?
The NPI number for Lauren Clark is 1063173557. It was assigned to this individual provider in the NPPES registry on January 6, 2022.
Where is Lauren Clark located?
Lauren Clark practices at 3401 Civic Center Blvd, Philadelphia, PA 19104. The listed phone number is (267) 250-8484.
What is Lauren Clark's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Pediatrics, with taxonomy code 363LP0200X.
Is Lauren Clark enrolled in Medicare?
Yes. Lauren Clark is registered in the Medicare PECOS enrollment system.
When was this NPI record last updated?
The NPPES record for Lauren Clark was last updated on March 12, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Lauren Wilson Clark, CRNP-AC · NPI 1063173557
Pediatrics physician in Philadelphia, Pennsylvania. Individual provider, active in the CMS NPPES registry since January 6, 2022.
## Identity
- **NPI:** 1063173557 (Entity type: Individual)
- **Enumerated:** January 6, 2022
- **Primary specialty:** Nurse Practitioner - Pediatrics · taxonomy 363LP0200X
- **State license:** SP025013 (Pennsylvania)
- **Sole proprietor:** Yes
## Practice location
- **Address:** 3401 CIVIC CENTER BLVD, Philadelphia, PA 19104-4319
- **Phone:** (267) 250-8484
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
## Record status
- **NPPES last updated:** March 12, 2026
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Source: [NPI Profile](https://npiprofile.com/npi/1063173557) · Data from the CMS NPPES public registry.