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Timetra Diane Clark, FNP-BC
Family Nurse Practitioner in Chicago, Illinois
NPI 1316687650

Timetra Diane Clark is a Family Nurse Practitioner based in Chicago, IL and is specialized in Family. Timetra Diane Clark practices in Chicago, IL and has the professional credentials of FNP-BC. The NPI Number for Timetra Diane Clark is 1316687650 and holds a License No. 041436444 (Illinois).

The current practice location address for Timetra Diane Clark is 1401 E 55Th St Apt 905N, Chicago, IL and can be reached out via phone at 708-759-3112.

Location: 1401 E 55Th St Apt 905N, Chicago, IL, 60615-5468
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1316687650
Provider Name
Timetra Diane Clark
Credential
FNP-BC
Provider Entity Type
Individual
Gender
Female
Address
1401 E 55Th St Apt 905N, Chicago, IL, 60615-5468
Phone Number
708-759-3112
Fax Number
Provider Enumeration Date
04/01/2022
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
1401 E 55Th St Apt 905N
City
Chicago
State
Illinois
Zip
60615-5468
Phone Number
708-759-3112
Fax Number
person
Provider Business Mailing Address Details
Address
1401 E 55Th St Apt 905N
City
Chicago
State
Illinois
Zip
60615-5468
Phone Number
708-759-3112
Fax Number
person
Provider's Taxonomy Details 1
Type
Nursing Service Providers
Classification
Registered Nurse
Speciality
Nephrology
Taxonomy
163WN0300X
License No.
209024791 (Illinois)
Definition
Definition to come...
person
Provider's Taxonomy Details 2
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
-
Taxonomy
363L00000X
License No.
9562544 (Florida)
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.
person
Provider's Taxonomy Details 3
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
Family
Taxonomy
363LF0000X
License No.
041436444 (Illinois)
Definition
Definition to come...
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