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

Mr. Phillip Wayne Clark, DNP

Individual provider Family Nurse Practitioner · NPI 1629471412

Mr. Phillip Wayne Clark, DNP is a Nurse Practitioner in Creve Coeur, Missouri. Qualified in 2014, 12 years ago. Practices as a sole proprietor, works from 4 locations and accepts Medicare assignment. Licensed in Arizona, Missouri and New Mexico.

Years since qualifying
12
Licensed in
AZ, MO, NM
In the registry since
2014
Specialties on file
3
What do these letters mean?
DNP — Doctor of Nursing Practice
The highest clinical degree in nursing.

See every abbreviation used in this directory →

Practice location Address checks out

11560 Olive Blvd
Creve Coeur, MO 63141-7111
Phone: (314) 995-7128
Fax: (314) 995-7221
Show map & directions

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

Additional practice locations (3)

  • 2501 N Stockton Hill Rd Ste 108, Kingman, AZ 86401-4140 — (928) 255-5050
  • 150 E. Tyson Rd, Quartzsite, AZ 85359-4618 — (928) 927-8749
  • 3100 Oak Grove Rd, Poplar Bluff, MO 63901-1573 — (573) 776-9290

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence AP 7468 (AZ)
Family Nurse Practitioner Taxonomy 363LF0000X · Licence CNP-02553 (NM)
Family Nurse Practitioner Taxonomy 363LF0000X · Licence 2014034806 (MO)

Record details

NPI number1629471412
Entity typeIndividual (Type 1)
GenderMale
Credentials DNP
Sole proprietorYes
NPI enumeratedOctober 7, 2014
Last updated in NPPESMarch 31, 2026
Certification dateMarch 31, 2026

Medicare enrollment

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

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2014 (12 years in practice)
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Creve Coeur