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

Kellyann T Clark, NP

Individual provider Adult Health Nurse Practitioner · NPI 1811249378

Kellyann T Clark, NP is a Nurse Practitioner in Falls Church, Virginia. Qualified in 2012, 14 years ago. Practices with Intensive Care Consortium Inc, a 483-clinician group and accepts Medicare assignment. Licensed in Virginia.

Years since qualifying
14
Licensed in
VA
In the registry since
2012
What do these letters mean?
NP — Nurse Practitioner
An advanced practice nurse who can diagnose, treat and in most states prescribe.

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Practice location Address checks out

3300 Gallows Rd
Falls Church, VA 22042-3307
Phone: (703) 776-3359
Fax: (703) 776-2338
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Adult Health Nurse Practitioner (primary) Taxonomy 363LA2200X · Licence 0024170317 (VA)

Record details

NPI number1811249378
Entity typeIndividual (Type 1)
GenderFemale
Credentials NP
Sole proprietorNo
NPI enumeratedOctober 9, 2012
Last updated in NPPESJanuary 27, 2022

Medicare enrollment

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

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2012 (14 years in practice)
Group practice Intensive Care Consortium Inc — 483 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations3 on file with Medicare

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