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Phillip Clark, DNP
NPI 1629471412 · on the registry since 2014 · sole proprietor
Practice
- Address
- 11560 Olive Blvd
Creve Coeur, MO 63141 - Phone
- (314) 995-7128
- Fax
- (314) 995-7221
- Organisation at this address
- Missouri Cvs Pharmacy, L.L.C.
Inferred from a shared address, not stated in the registry.
- Clinicians at this address
- 21
Additional practice sites
- 2501 N Stockton Hill Rd Ste 108, Kingman, AZ
- 150 E. Tyson Rd, Quartzsite, AZ
- 3100 Oak Grove Rd, Poplar Bluff, MO
Registry record
- Primary taxonomy
- Family Nurse Practitioner
363LF0000X
- Also registered as
- Family Nurse Practitioner
Family Nurse Practitioner - Licence states on file
- AZ, NM, MO
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2026-03-31
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Missouri