Provider Demographics
NPI:1366740979
Name:CLARKE, NADINE A (NP-C)
Entity type:Individual
Prefix:MS
First Name:NADINE
Middle Name:A
Last Name:CLARKE
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7754 OKEECHOBEE BOULEVARD
Mailing Address - Street 2:P.O. BOX 445
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33411
Mailing Address - Country:US
Mailing Address - Phone:561-331-3577
Mailing Address - Fax:561-331-3778
Practice Address - Street 1:2054 VISTA PARKWAY EMERALD VIEW
Practice Address - Street 2:400
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33411
Practice Address - Country:US
Practice Address - Phone:561-576-7879
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-03-06
Last Update Date:2025-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9189895363LF0000X, 363LP0808X
FLARNP-9189895363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL012327500Medicaid
FLP01422790-EFF6/30/14OtherRAILROAD MEDICARE-DV3514- WPB,RB
FLP01422790-EFF6/30/14OtherRAILROAD MEDICARE-DV3514- WPB,RB