| Doctor Name: | MS. BERNICE L CLARK |
| NPI Number: | 1174515795 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | C.R.N.P. |
| License Number: | SP007726 |
| Business Practice Address: | 132 Grove St Haddonfield, NJ - 080331224 |
| Business Phone Number: | 8563542211 |
| Business Fax Number: | 8563546181 |
| Mailing Address: | 402 Lippincott Dr, MARLTON |
| State: | NJ |
| Postal Code: | 080534112 |
| Phone Number: | 8567823300 |
| Fax Number: | 8565048029 |
| NPI Enumeration Date: | 08/19/2005 |
| NPI Last Update Date: | 04/08/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | SP007726 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | PA |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |