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

Lauren Wilson Clark, CRNP-AC

Individual provider Pediatric Nurse Practitioner · NPI 1063173557

Lauren Wilson Clark, CRNP-AC is a Pediatric Nurse Practitioner in Philadelphia, Pennsylvania. Practices as a sole proprietor. Licensed in Pennsylvania.

Licensed in
PA
In the registry since
2022

Practice location Address checks out

3401 Civic Center Blvd
Philadelphia, PA 19104-4319
Phone: (267) 250-8484
Show map & directions

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

Specialties & licences

Pediatric Nurse Practitioner (primary) Taxonomy 363LP0200X · Licence SP025013 (PA)

Record details

NPI number1063173557
Entity typeIndividual (Type 1)
GenderFemale
Credentials CRNP-AC
Sole proprietorYes
NPI enumeratedJanuary 6, 2022
Last updated in NPPESMarch 12, 2026
Certification dateMarch 12, 2026

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