MRS. REBECCA THERESA CLARK (NPI# 1114331543) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114331543 |
| Entity Type | Individual |
| Full Name | MRS. REBECCA THERESA CLARK |
| Credential | RN |
| Practice Address |
3236 Kirkman St Lake Charles LA 70601-8640 |
| Mailing Address |
1120 Lasalette Ave Sulphur LA 70663-5124 |
| Practice Telephone | 3374786020 |
| Practice Fax Number | 3374754820 |
| Mailing Telephone | 3373047985 |
| Enumeration Date | 2014-06-13 |
| Last Update Date | 2014-06-13 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 163WC1500X |
Registered Nurse Specialization: Community Health |
RN088489 | LA | Nursing Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558978833 | Rebecca Clark | Massage Therapist | 244 Madison Ave # 391, New York, NY 10016-2817 | 2020-09-30 |
| 1184130759 | Rebecca Lee Clark | Registered Nurse | 2435 Kimberly Rd Ste 10n, Bettendorf, IA 52722-3572 | 2017-12-19 |
| 1144761099 | Rebecca Clark | Counselor | 24401 W 39th St S, Goddard, KS 67052-8713 | 2017-03-11 |
| 1437589199 | Rebecca Scoggin Clark | Nurse Practitioner | 413 Mcconnell Street, Jefferson, NC 28640 | 2013-11-16 |
| 1861557563 | Rebecca Clark | Respite Care | 2703 S 37th Dr, Yuma, AZ 85364-5983 | 2006-12-25 |
| 1831112671 | Rebecca Jand Clark | Counselor | 1501 San Pedro Se (116), Albuquerque, NM 87108 | 2006-07-25 |
| 1922067859 | Rebecca A Clark | Physician Assistant | 664 N Main St, Pearson, GA 31642 | 2006-03-20 |
| 1124004700 | Rebecca Elizabeth Clark | Nurse Practitioner | 1811 State St, Nashville, TN 37203-2205 | 2005-12-15 |
| 1841811098 | Rebecca L Clark | Behavior Technician | 9900 Gilmore Ridge Rd, Nashville, IN 47448-9731 | 2020-04-29 |
| 1073149167 | Rebecca Maria Clark | Genetic Counselor, MS | Upmc Children's Hospital of Pittsburgh, 4401 Penn Avenue, Pittsburgh, PA 15224-1334 | 2020-03-20 |
| Street Address |
3236 KIRKMAN ST |
| City | LAKE CHARLES |
| State | LA |
| Zip Code | 70601-8640 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104820521 | Beverly Alice Hiatt | Nurse Practitioner | 3236 Kirkman St, Lake Charles, LA 70601-8640 | 2005-06-13 |
| 1396396040 | Heidi Crystal Wooten | Registered Nurse | 3236 Kirkman St, Lake Charles, LA 70601-8640 | 2019-09-24 |
| 1255819595 | Myra S Vincent | Registered Nurse | 3236 Kirkman St, Lake Charles, LA 70601-8640 | 2018-07-30 |
| 1841649043 | Laura Webb | Registered Nurse | 3236 Kirkman St, Lake Charles, LA 70601-8640 | 2016-06-08 |
| 1760842488 | Amy Donovan | Registered Nurse | 3236 Kirkman St, Lake Charles, LA 70601-8640 | 2016-02-24 |
| 1841629789 | Kelly Bower | Registered Nurse | 3236 Kirkman St, Lake Charles, LA 70601-8640 | 2013-11-01 |
| 1104172261 | Tracey Elizabeth Timmons | Dietitian, Registered | 3236 Kirkman St, Lake Charles, LA 70601-8640 | 2012-07-26 |
| 1750636783 | Lisa Sullivan | Registered Nurse | 3236 Kirkman St, Lake Charles, LA 70601-8640 | 2012-07-16 |
| 1104181320 | Marsha L Goodly | Registered Nurse | 3236 Kirkman St, Lake Charles, LA 70601-8640 | 2012-07-13 |
| 1285989418 | Contessa Guillory-brown | Registered Nurse | 3236 Kirkman St, Lake Charles, LA 70601-8640 | 2012-07-13 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144833872 | Fresenius Medical Care Sulphur, LLC | Clinic/Center | 330 Chavanne Street, Lake Charles, LA 70601 | 2020-08-24 |
| 1174158844 | Andrea Cormier | Peer Specialist | 751 E Bayou Pines Drive, Suite C, Lake Charles, LA 70601 | 2020-03-03 |
| 1588297303 | Vivian Claire Miller Monceaux | Chiropractor | 780 Bayou Pines East Drive, Lake Charles, LA 70601 | 2020-02-20 |
| 1568001014 | Swla Center for Health Services | Clinic/Center | 3820 Senator J. Bennett Johnston Ave, Charleston Bldg 8, Lake Charles, LA 70601 | 2020-01-02 |
| 1417512070 | Ryan Nathaniel Vaisler | Student in an Organized Health Care Education/Training Program | 1525 Oak Park Blvd., Lake Charles, LA 70601 | 2019-05-08 |
| 1336600675 | Hoh Palliative Care, LLC | Family Medicine | 750 East Bayou Pines, Suite A, Lake Charles, LA 70601 | 2019-03-28 |
| 1073079026 | Alawrass LLC | Pharmacy | 803 E Prien Lake Rd, Lake Charles, LA 70601 | 2019-02-14 |
| 1861962722 | Ellaweena Woods | Counselor | 1409 Kirkman St., Lake Charles, LA 70601 | 2018-12-04 |
| 1770051963 | Hanna Marie Rodriguez | Counselor | 751 Bayou Pines Drive, Suite C, Lake Charles, LA 70601 | 2018-11-06 |
| 1023585213 | Shandora Druilhet | Case Manager/Care Coordinator | 751 E Bayou Pines, Lake Charles, LA 70601 | 2018-10-26 |
| Find all providers in zip 70601 | ||||
| Taxonomy Code | 163WC1500X |
| Grouping | Nursing Service Providers |
| Classification | Registered Nurse |
| Specialization | Community Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548522444 | Jeanne Lejeune Fontenot | Registered Nurse | 707 E Prien Lake Rd Ste A, Lake Charles, LA 70601-8788 | 2012-06-15 |
| 1396396040 | Heidi Crystal Wooten | Registered Nurse | 3236 Kirkman St, Lake Charles, LA 70601-8640 | 2019-09-24 |
| 1255819595 | Myra S Vincent | Registered Nurse | 3236 Kirkman St, Lake Charles, LA 70601-8640 | 2018-07-30 |
| 1841649043 | Laura Webb | Registered Nurse | 3236 Kirkman St, Lake Charles, LA 70601-8640 | 2016-06-08 |
| 1760842488 | Amy Donovan | Registered Nurse | 3236 Kirkman St, Lake Charles, LA 70601-8640 | 2016-02-24 |
| 1841629789 | Kelly Bower | Registered Nurse | 3236 Kirkman St, Lake Charles, LA 70601-8640 | 2013-11-01 |
| 1528401924 | Cynthia Guillory Hymel | Registered Nurse | 707 E Prien Lake Rd Ste A, Lake Charles, LA 70601-8788 | 2013-04-16 |
| 1750636783 | Lisa Sullivan | Registered Nurse | 3236 Kirkman St, Lake Charles, LA 70601-8640 | 2012-07-16 |
| 1104181320 | Marsha L Goodly | Registered Nurse | 3236 Kirkman St, Lake Charles, LA 70601-8640 | 2012-07-13 |
| 1285989418 | Contessa Guillory-brown | Registered Nurse | 3236 Kirkman St, Lake Charles, LA 70601-8640 | 2012-07-13 |
| Find all providers in LAKE CHARLES | ||||
| City | LAKE CHARLES |
| Zip Code | 70601 |
Please comment or provide details below to improve the information on MRS. REBECCA THERESA CLARK.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.