| Doctor Name: | DR. AMANDA LYNN CLARK |
| NPI Number: | 1013340462 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | DNP WCC AGNP-C |
| License Number: | SP012941 |
| Business Practice Address: | 150 Scharberry Ln Mars, PA - 160462430 |
| Business Phone Number: | 8003558894 |
| Business Fax Number: | |
| Mailing Address: | 150 Scharberry Ln, MARS |
| State: | PA |
| Postal Code: | 160462430 |
| Phone Number: | 8003558894 |
| Fax Number: | |
| NPI Enumeration Date: | 08/20/2013 |
| NPI Last Update Date: | 08/20/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LG0600X |
| License Number: | SP012941 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | PA |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Gerontology |
| Taxonomy Definition: | |