DoctorDataHub
Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

MR. PHILLIP WAYNE CLARK, DNP

Active Sole Proprietor

MR. PHILLIP WAYNE CLARK, DNP is a Family Nurse Practitioner healthcare provider located in KINGMAN, Arizona. NPI 1629471412 is currently active in the NPPES registry. Verify at CMS.

Family Nurse Practitioner · KINGMAN, AZ

Registration Details

NPI Number
1629471412
Provider Type
Individual
Gender
Male
NPI Issued
Oct 7, 2014 (11.818647216801 yrs)
Last Updated
May 23, 2025
Licenses
2014034806 (MO)
CNP-02553 (NM)
AP 7468 (AZ)
Sole Proprietor
Yes

Practice Information

Address
2501 N STOCKTON HILL RD STE 108
KINGMAN, AZ, 864014140
Browse AZ providers · Browse ZIP 86401
Phone
9282555050
Fax
8885715897
Primary Specialty
Family Nurse Practitioner
363LF0000X
Additional Specialty
Family Nurse Practitioner
Additional Specialty
Family Nurse Practitioner

Other Family Nurse Practitioner Providers in KINGMAN, AZ

Name Credential NPI
MRS. KATHLEEN SUZANNE FLOREA NP 1275527764
MRS. CHERYL LYNN WEBB 1891772083
ERNEST S MONSON NP 1861457855
JULIE D WAITE ARNP 1245268788
VIVIAN R. SMITH NP 1851305981
MS. RUTH ELAINE FOWLER FNP/BC 1639339179
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.