Provider Demographics
NPI:1659071801
Name:CLARKE, KATHERINE (CRNP)
Entity Type:Individual
Prefix:
First Name:KATHERINE
Middle Name:
Last Name:CLARKE
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 645306
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15264-5251
Mailing Address - Country:US
Mailing Address - Phone:844-801-8400
Mailing Address - Fax:412-330-5411
Practice Address - Street 1:3824 NORTHERN PIKE STE 200
Practice Address - Street 2:
Practice Address - City:MONROEVILLE
Practice Address - State:PA
Practice Address - Zip Code:15146-2173
Practice Address - Country:US
Practice Address - Phone:412-380-2800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-07
Last Update Date:2023-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP027067363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily