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

Nadia Shanise Clark, FNP-C

Individual provider Family Nurse Practitioner · NPI 1689345506

Nadia Shanise Clark, FNP-C is a Nurse Practitioner in Hattiesburg, Mississippi. Qualified in 2021, 5 years ago. Accepts Medicare assignment and offers telehealth. Licensed in Mississippi.

Years since qualifying
5
Licensed in
MS
In the registry since
2021
What do these letters mean?
FNP-C — Family Nurse Practitioner, Certified
A family nurse practitioner certified by the AANP.

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Practice location Address checks out

5056 W 4th St # 100
Hattiesburg, MS 39402-1069
Phone: (601) 446-2056
Fax: (949) 288-0396
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence 904907 (MS)

Record details

NPI number1689345506
Entity typeIndividual (Type 1)
GenderFemale
Credentials FNP-C
Sole proprietorNo
NPI enumeratedSeptember 21, 2021
Last updated in NPPESMay 21, 2025
Certification dateMay 21, 2025

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 Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations5 on file with Medicare

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