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

Shana Marie Clark

Individual provider Family Nurse Practitioner · NPI 1710407218

Shana Marie Clark is a Nurse Practitioner in Louisville, Kentucky. Qualified in 2017, 9 years ago. Practices with Little Clinic of in LLC, a 69-clinician group and accepts Medicare assignment. Licensed in Kentucky.

Years since qualifying
9
Licensed in
KY
In the registry since
2017
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Practice location Address checks out

6101 Terry Rd
Louisville, KY 40258-3027
Phone: (502) 807-5943
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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 3011392 (KY)

Record details

NPI number1710407218
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedJune 26, 2017
Last updated in NPPESJuly 21, 2022

Medicare enrollment

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

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2017 (9 years in practice)
Group practice Little Clinic Of In Llc — 69 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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