Timetra Diane Clark, FNP-BC
Timetra Diane Clark, FNP-BC is a Nurse Practitioner in Chicago, Illinois. Qualified in 2021, 5 years ago. Practices as a sole proprietor and works from 2 locations. Licensed in Florida and Illinois.
- Years since qualifying
- 5
- Licensed in
- FL, IL
- In the registry since
- 2022
- Specialties on file
- 4
What do these letters mean?
- FNP-BC — Family Nurse Practitioner, Board Certified
- A family nurse practitioner certified by the ANCC.
Practice location Address checks out
1401 E 55th St Apt 905NChicago, IL 60615-5468
Phone: (708) 759-3112
Show map & directions
Directions in Google Maps · Apple Maps · OpenStreetMap
Pin is approximate — placed at the ZIP-code centre, not the exact door.
Additional practice locations (1)
- 11026 Pony Gate, San Antonio, TX 78254-5999 — (847) 616-0269
Specialties & licences
| Family Nurse Practitioner (primary) | Taxonomy 363LF0000X · Licence 209024791 (IL) |
|---|---|
| Nephrology Registered Nurse | Taxonomy 163WN0300X · Licence 041436444 (IL) |
| Nephrology Registered Nurse | Taxonomy 163WN0300X · Licence 9562544 (FL) |
| Nurse Practitioner | Taxonomy 363L00000X · Licence 209024791 (IL) |
Record details
| NPI number | 1316687650 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Female |
| Credentials | FNP-BC |
| Sole proprietor | Yes |
| NPI enumerated | April 1, 2022 |
| Last updated in NPPES | April 1, 2022 |
| Certification date | April 1, 2022 |
Medicare enrollment
| Medicare specialty | NURSE PRACTITIONER |
|---|---|
| Medical school | OTHER |
| Graduated | 2021 (5 years in practice) |
| Accepts Medicare assignment | Not indicated |
| Practice locations | 2 on file with Medicare |