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

Shalita Clark, CRNP

Individual provider Psychiatric/Mental Health Nurse Practitioner · NPI 1396214060

Shalita Clark, CRNP is a Nurse Practitioner in Bronx, New York. Qualified in 2018, 8 years ago. Practices with Physician Affiliate Group of New York PC, a 1,224-clinician group, accepts Medicare assignment and offers telehealth. Licensed in Alabama, California, Indiana and New York.

Years since qualifying
8
Licensed in
AL, CA, IN, NY
In the registry since
2018
Specialties on file
4
What do these letters mean?
CRNP — Certified Registered Nurse Practitioner
The title Pennsylvania and some other states use for a nurse practitioner.

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Practice location Address checks out

234 E 149th St
Bronx, NY 10451-5504
Phone: (718) 579-5006
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Psychiatric/Mental Health Nurse Practitioner (primary) Taxonomy 363LP0808X · Licence CV2100304 (IN)
Psychiatric/Mental Health Nurse Practitioner Taxonomy 363LP0808X · Licence 402966V (NY)
Psychiatric/Mental Health Nurse Practitioner Taxonomy 363LP0808X · Licence 1-147364 (AL)
Psychiatric/Mental Health Nurse Practitioner Taxonomy 363LP0808X · Licence 95010591 (CA)

Record details

NPI number1396214060
Entity typeIndividual (Type 1)
GenderFemale
Credentials CRNP
Sole proprietorNo
NPI enumeratedNovember 24, 2018
Last updated in NPPESApril 22, 2022
Certification dateApril 14, 2021

Medicare enrollment

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

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2018 (8 years in practice)
Group practice Physician Affiliate Group Of New York Pc — 1224 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations2 on file with Medicare

Other providers in Bronx