JUDITH CR CLARK NP
NPI 1780682138
Nurse Practitioner in Farmington Hills, MI

Q: What is Judith Clark's NPI number?

The NPI number for Judith Clark is 1780682138. It was assigned to this individual provider in the NPPES registry on July 11, 2005.

Q: What is Judith Clark's specialty?

The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.

Q: When was this NPI record last updated?

The NPPES record for Judith Clark was last updated on June 20, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.

Active since July 11, 2005

32605 W 12 MILE RD STE 195, FARMINGTON HILLS, MI 48334(313) 306-2023 Get Directions Write a Review

NPPES record last updated: June 20, 2022. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Judith Cr Clark Np NPPES

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

JUDITH CR CLARK NP (NPI 1780682138) is an individual nurse practitioner in Farmington Hills, Michigan, licensed in Michigan (4704171391) and active in the NPI registry since July 2005. She maintains a secondary practice location in Ann Arbor.

NPPES Registry Identity

NPI1780682138

Entity TypeIndividualFemale

Primary Taxonomy363L00000X

Provider Legal NameJUDITH CR CLARKCredential: NP

Location Address32605 W 12 MILE RD STE 195Farmington Hills, MI 48334-3390

Mailing Address3621 S State St, 700 Kms PlaceAnn Arbor, MI 48108 · (734) 936-2047

Phone(313) 306-2023

Sole ProprietorNo

Enumeration DateJuly 11, 2005

Last NPPES UpdateJune 20, 2022

NPPES CertifiedJune 20, 2022

✔ NPI 1780682138 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363L00000X

License✔ Licensed in MI · 4704171391

Definition

(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.

32605 W 12 MILE RD STE 195, Farmington Hills, MI 48334

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Secondary Practice Location 1

Location 1375 Briarwood CirAnn Arbor, MI 48108-1605 · Phone (734) 998-7207

Other Identifiers 3

Other5008707110MI · Bcbsm

OtherP00365326MI · Medicare-railroad

Medicaid4643072MI

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Priority Health.Insurance ›

Other Providers at the Same Location NPPES 11

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

TAMIKA DAVIS NP

Nurse Practitioner (Adult Health)