Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Andrea Clark

Individual provider Primary Care Nurse Practitioner · NPI 1992598379

Andrea Clark is a Nurse Practitioner in Glenside, Pennsylvania. Qualified in 2021, 5 years ago. Practices as a sole proprietor. Licensed in Pennsylvania.

Years since qualifying
5
Licensed in
PA
In the registry since
2025

Practice location Address checks out

721 N Tyson Ave
Glenside, PA 19038-3845
Phone: (267) 921-8158
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Primary Care Nurse Practitioner (primary) Taxonomy 363LP2300X · Licence SP032962 (PA)

Record details

NPI number1992598379
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedMay 27, 2025
Last updated in NPPESMay 27, 2025
Certification dateMay 27, 2025
Mailing address721 N Tyson Ave, Glenside, PA 19038-3845

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2021 (5 years in practice)
Accepts Medicare assignment Not indicated