LYREVA J CLARK RNFNP-C
NPI 1548246747
Nurse Practitioner - Family in Hannibal, MO
About Lyreva J Clark Rnfnp-c NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
LYREVA J CLARK RNFNP-C (NPI 1548246747) is an individual family provider in Hannibal, Missouri, licensed in Missouri (2003005715) and active in the NPI registry since December 2005. She maintains 2 additional practice locations.
NPPES Registry Identity
Specialties & Licenses
Other Names 1
Secondary Practice Locations 2
Other Identifiers 1
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.
HANNIBAL, MO 63401
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 Lyreva Clark's NPI number?
The NPI number for Lyreva Clark is 1548246747. It was assigned to this individual provider in the NPPES registry on December 20, 2005. The provider is also known as Lyreva J Nollette Rnfnp-C.
Where is Lyreva Clark located?
Lyreva Clark practices at 6500 Hospital Dr, Hannibal, MO 63401. The listed phone number is (573) 629-3400.
What is Lyreva 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 Lyreva Clark was last updated on September 28, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.
# Lyreva J Clark, RNFNP-C · NPI 1548246747
Family physician in Hannibal, Missouri. Individual provider, active in the CMS NPPES registry since December 20, 2005.
## Identity
- **NPI:** 1548246747 (Entity type: Individual)
- **Enumerated:** December 20, 2005
- **Primary specialty:** Nurse Practitioner - Family · taxonomy 363LF0000X
- **State license:** 2003005715 (Missouri)
- **Sole proprietor:** No
## Practice location
- **Address:** 6500 HOSPITAL DR, Hannibal, MO 63401-6890
- **Phone:** (573) 629-3400
## Record status
- **NPPES last updated:** September 28, 2022
- **Other identifiers:** Medicaid 429238306 (MO)
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Source: [NPI Profile](https://npiprofile.com/npi/1548246747) · Data from the CMS NPPES public registry.