MRS. KIMBERLY SUE CLARK (NPI# 1114996931) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114996931 |
| Entity Type | Individual |
| Full Name | MRS. KIMBERLY SUE CLARK |
| Credential | LPN |
| Practice Address |
4563 S Ridge Rd E Geneva OH 44041-7310 |
| Practice Telephone | 4404150844 |
| Mailing Telephone | 4404150844 |
| Enumeration Date | 2006-03-15 |
| Last Update Date | 2007-07-09 |
| Gender Code | F |
| Is Sole Proprietor | X |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 164W00000X | Licensed Practical Nurse | PN096694 | OH | Nursing Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OH | 2123991 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902362452 | Kimberly Michelle Clark | Technician, Other | 2819 Se Brodiaea Ct, Hillsboro, OR 97123-5201 | 2019-02-20 |
| 1780037994 | Kimberly Clark | Nurse Practitioner | 11251 Westwood Ave, Denham Springs, LA 70726-6947 | 2016-07-22 |
| 1053651869 | Kimberly Gail Clark | Hearing Instrument Specialist | 401 Apperson Dr, Salem, VA 24153-7026 | 2013-02-15 |
| 1952660524 | Kimberly Jo Clark | Licensed Practical Nurse | 334 Elmwood Ave, Barberton, OH 44203-1153 | 2012-05-16 |
| 1336421999 | Kimberly D Clark | Speech-Language Pathologist | 1524 Lexington Road, Clovis, NM 88101-6846 | 2011-09-09 |
| 1376878595 | Kimberly Clark | Physical Therapist | 101 S Kraemer Blvd Ste 125, Placentia, CA 92870-6100 | 2009-10-06 |
| 1609050913 | Kimberly Irene Clark | Counselor | 3077 Coolidge Ave, Costa Mesa, CA 92626-2809 | 2007-12-21 |
| 1053591875 | Kimberly Ann Clark | Counselor | 1516 S Boston Ave, Suite 100, Tulsa, OK 74119-4003 | 2007-11-08 |
| 1841400868 | Kimberly Clark | Social Worker | 4350 Woodland Ave, Jackson, MS 39206-3955 | 2007-05-22 |
| 1902900293 | Kimberly A Clark | Physical Therapist | 614 Monkton Rd, Bristol, VT 05443-5392 | 2006-09-08 |
| Street Address |
4563 S RIDGE RD E |
| City | GENEVA |
| State | OH |
| Zip Code | 44041-7310 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922564376 | 599 West Main Corporation | Intermediate Care Facility, Mentally Retarded | 609 West Main Street, Geneva, OH 44041 | 2019-02-11 |
| 1275887713 | Equal Opportunity Housing, LLC | Intermediate Care Facility, Mentally Retarded | 1200 Sawyer Drive, Geneva, OH 44041 | 2012-11-06 |
| 1588967491 | Megann Harris | Dietitian, Registered | 870 W. Main St., Geneva, OH 44041 | 2010-12-15 |
| 1801073523 | University Primary Care Practices Inc | Orthopaedic Surgery | 890 W Main St # 202, Geneva, OH 44041 | 2008-01-24 |
| 1336349661 | Daniel Edward Walsh | Psychologist | 5187 Old Lake Rd, Geneva, OH 44041 | 2007-07-24 |
| 1992927206 | Darlas Health Care | Exclusive Provider Organization | 481 Blaine, Geneva, OH 44041 | 2007-05-03 |
| 1699987867 | Driftwood Industries LLC | Day Training, Developmentally Disabled Services | 185 Water St., Geneva, OH 44041 | 2007-05-03 |
| 1487866638 | 599 West Main Corporation | Intermediate Care Facility, Mentally Retarded | 599 West Main St., Geneva, OH 44041 | 2007-05-03 |
| 1902964273 | Maaike Ann Jenkins | Physical Therapist | 96 Broadway Street, Geneva, OH 44041 | 2006-12-05 |
| 1265501019 | Northwest Ambulance District | Ambulance | 1480 South Broadway, Geneva, OH 44041 | 2006-11-07 |
| Find all providers in zip 44041 | ||||
| Taxonomy Code | 164W00000X |
| Grouping | Nursing Service Providers |
| Classification | Licensed Practical Nurse |
| An individual with post-high school vocational training and practical experience in the provision of nursing care at a level less than that required for certification as a Registered Nurse. Requirements for education, experience, licensure, and job responsibilities vary among the states. |
| Notes: Source: Rhea, Ott, and Shafritz, The Facts On File Dictionary of Health Care Management, New York: Facts On File Publications, 1988. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104449040 | Mariah P Rodriguez | Licensed Practical Nurse | 304 Genesis Way, Geneva, NY 14456-2076 | 2020-05-27 |
| 1316568058 | Brandy Crocker | Licensed Practical Nurse | 14 Middle St, Geneva, NY 14456-1810 | 2020-05-05 |
| 1245851948 | Marissa Iddings | Licensed Practical Nurse | 71 Sherrill St, Geneva, NY 14456-1156 | 2020-05-04 |
| 1417595778 | Taylor Conrad | Licensed Practical Nurse | 20 Bay View Ter, Geneva, NY 14456-9768 | 2019-12-18 |
| 1932746682 | Vanessa Mcgroder | Licensed Practical Nurse | 5261 E Maple Rd, Geneva, OH 44041-9002 | 2019-12-02 |
| 1679048367 | Amanda Ashley Russ | Licensed Practical Nurse | 178 William St, Geneva, NY 14456-2554 | 2018-10-09 |
| 1063961746 | Christina Brennan | Licensed Practical Nurse | 601b W. Washinton St, Geneva, NY 14456 | 2016-09-23 |
| 1275992364 | Lourdes Arambarry | Licensed Practical Nurse | 49 West St, Geneva, NY 14456-2520 | 2016-02-17 |
| 1578941993 | Eileen Modaffari | Licensed Practical Nurse | 2760 County Road 6 Lot 24, Geneva, NY 14456-9552 | 2015-05-18 |
| 1083001960 | Theresa Lynn Gentile | Licensed Practical Nurse | 50 Avenue E, Geneva, NY 14456-1058 | 2015-04-18 |
| Find all providers in GENEVA | ||||
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| 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.