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DEIRDRA CLARK FNP (NP-C)
NPI 1215306774
Nurse Practitioner - Family in Tabb, VA

Active since September 15, 2015
5007 #2 VICTORY BLVD., TABB, VA 23693(757) 234-7987 Get Directions Write a Review

NPPES record last updated: September 15, 2015. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Deirdra Clark Fnp (np-c) NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DEIRDRA CLARK FNP (NP-C) (NPI 1215306774) is an individual family provider in Tabb, Virginia, licensed in Virginia (0024172570) and active in the NPI registry since September 2015.

NPPES Registry Identity

NPI1215306774
Entity TypeIndividualFemale
Primary Taxonomy363LF0000X
Provider Legal NameDEIRDRA CLARKCredential: FNP (NP-C)
Location Address5007 #2 VICTORY BLVD.Tabb, VA 23693-5606
Mailing Address2620 Elm Hill PikeNashville, TN 37214-3108 · (615) 425-4200
Phone(757) 234-7987
Sole ProprietorNo
Enumeration DateSeptember 15, 2015
✔ NPI 1215306774 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
License✔ Licensed in VA · 0024172570
5007 #2 VICTORY BLVD., Tabb, VA 23693
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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 Deirdra Clark's NPI number?

The NPI number for Deirdra Clark is 1215306774. It was assigned to this individual provider in the NPPES registry on September 15, 2015.

Where is Deirdra Clark located?

Deirdra Clark practices at 5007 #2 Victory Blvd., Tabb, VA 23693. The listed phone number is (757) 234-7987.

What is Deirdra Clark's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

When was this NPI record last updated?

The NPPES record for Deirdra Clark was last updated on September 15, 2015. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 years 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.