CHARLENE CLARK (NPI# 1144621756) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1144621756 |
| Entity Type | Individual |
| Full Name | CHARLENE CLARK |
| Credential | FNP |
| Practice Address |
840 E Hill Ave Moses Lake WA 98837-2238 |
| Mailing Address |
820 N Chelan Ave Wenatchee WA 98801-2028 |
| Practice Telephone | 5096638711 |
| Practice Fax Number | 7316584079 |
| Mailing Telephone | 5096638711 |
| Enumeration Date | 2014-09-15 |
| Last Update Date | 2020-09-24 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
AP61098520 | WA | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363LF0000X |
Nurse Practitioner Specialization: Family |
19070 | TN | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TN | APN LICENSE | 19070 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669804886 | Charlene M Clark | Licensed Practical Nurse | 27 Heyward St, Brentwood, NY 11717-1909 | 2013-07-31 |
| 1245878156 | Charlene Renee Clark | Technician | 1711 E Desert Inn Rd, Las Vegas, NV 89169-3201 | 2019-12-11 |
| 1538700927 | Charlene Clark | Physical Therapy Assistant | 4707 140th Ave N Ste 313, Clearwater, FL 33762-3841 | 2019-10-07 |
| Street Address |
840 E HILL AVE |
| City | MOSES LAKE |
| State | WA |
| Zip Code | 98837-2238 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275539256 | Kimberlee Elizabeth Poole | Nurse Practitioner | 840 E Hill Ave, Moses Lake, WA 98837-2238 | 2005-06-23 |
| 1366041188 | Breanne Mcintyre | Dietitian, Registered | 840 E Hill Ave, Moses Lake, WA 98837-2238 | 2020-10-22 |
| 1164036224 | Jennipher Colas | Physician Assistant | 840 E Hill Ave, Moses Lake, WA 98837-2238 | 2020-09-04 |
| 1609431709 | Andrew James Nielsen | Physician Assistant | 840 E Hill Ave, Moses Lake, WA 98837-2238 | 2019-05-03 |
| 1669931705 | Michael Johnson | Physician Assistant | 840 E Hill Ave, Moses Lake, WA 98837-2238 | 2019-03-18 |
| 1609340074 | Reaghan Kathleen Siebein | Nurse Practitioner | 840 E Hill Ave, Moses Lake, WA 98837-2238 | 2019-01-18 |
| 1578036315 | Rachel M Ebeling | Counselor | 840 E Hill Ave, Moses Lake, WA 98837-2238 | 2019-01-04 |
| 1891267951 | Darren Scott Trofibio | Nurse Practitioner | 840 E Hill Ave, Moses Lake, WA 98837-2238 | 2018-12-28 |
| 1083166813 | Braeden R Cook | Nurse Practitioner | 840 E Hill Ave, Moses Lake, WA 98837-2238 | 2016-10-27 |
| 1942650437 | Kelley L Drayer | Counselor | 840 E Hill Ave, Moses Lake, WA 98837-2238 | 2016-06-15 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316447097 | Lateef Ajani Olaniyan | Pharmacist | 2709 W Broadway Avenue, Southgate Pharmacy, Moses Lake, WA 98837 | 2018-02-19 |
| 1982117651 | Amanda M Cross | Massage Therapist | 2200 S. Maiers Rd., Suite B, Moses Lake, WA 98837 | 2017-11-15 |
| 1962928200 | E & H Holdings, LLC | Family Medicine | 708 E Penn St, Moses Lake, WA 98837 | 2017-08-18 |
| 1912366881 | Tara L Zamarron | Nurse Practitioner | 1550 S. Pioneer Way, Samaritan Family Physicians, Moses Lake, WA 98837 | 2016-02-19 |
| 1124401732 | Christian Mmadibuobu Okafor | Dentist | 605 South Coolidge Street, Moses Lake Community Health Center, Moses Lake, WA 98837 | 2015-06-30 |
| 1790182004 | Tari Ann Devaney | Dental Hygienist | 605 Coolidge Drive, Moses Lake, WA 98837 | 2014-12-02 |
| 1356746150 | Anna Marie Peterson | Counselor | 814 S. Wilder St., Moses Lake, WA 98837 | 2014-10-23 |
| 1699119495 | Geoffrey T. Ping D.d.s. and Asia Dela Cruz D.d.s. Pllc | Dentist | 800 N. Stratford Rd., Moses Lake, WA 98837 | 2013-04-23 |
| 1831433325 | George Kenyon Exeter | Physical Therapy Assistant | 817 E Plum Ave, Moses Lake, WA 98837 | 2012-11-21 |
| 1114219698 | Sound Oxygen Service Inc | Durable Medical Equipment & Medical Supplies | 1010 S Pioneer Way Ste C, Moses Lake, WA 98837 | 2011-05-03 |
| Find all providers in zip 98837 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396247417 | Amber D Dacy | Nurse Practitioner | 1530 Pilgrim St, Moses Lake, WA 98837-4623 | 2018-03-05 |
| 1912366881 | Tara L Zamarron | Nurse Practitioner | 1550 S. Pioneer Way, Samaritan Family Physicians, Moses Lake, WA 98837 | 2016-02-19 |
| 1467754010 | Tamera R Nolan | Nurse Practitioner | 1555 S. Pilgrim St, Moses Lake, WA 98837-4623 | 2010-12-01 |
| 1790932085 | Sharon L Southwick | Nurse Practitioner | 801 Wheeler Rd, Emergency Dept, Moses Lake, WA 98837 | 2008-08-19 |
| 1699017632 | John Frederick Leonard Jamison | Nurse Practitioner | 605 S Coolidge St, Moses Lake, WA 98837-1893 | 2013-03-16 |
| 1851641971 | Maureen Joan Gallagher | Nurse Practitioner | 605 S Coolidge St, Moses Lake, WA 98837-1893 | 2012-09-17 |
| 1437313640 | Kristine E Kehler | Nurse Practitioner | 605 S Coolidge St, Moses Lake, WA 98837-1893 | 2008-07-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740889369 | Abigail E Mercure | Nurse Practitioner | 7618 Ne Champagne Point Pl, Kirkland, WA 98034-3448 | 2020-10-24 |
| 1043819907 | Matthew Sean Krabbendam | Nurse Practitioner | 7315 212th St Sw Ste 207, Edmonds, WA 98026-7610 | 2020-10-21 |
| 1700485919 | Yanique Ricie Nana Yakam Azah | Nurse Practitioner | 22829 Se 239th Ct, Maple Valley, WA 98038-5052 | 2020-10-19 |
| 1164029484 | Chelsea Lauren Bresnahan | Nurse Practitioner | 7928 S Parway Ln, Cheney, WA 99004-8619 | 2020-10-08 |
| 1023615549 | Brian D Ottesen | Nurse Practitioner | 2315 Crestwood Pl Nw, Olympia, WA 98502-4095 | 2020-10-07 |
| 1881291003 | Allison Walzer | Nurse Practitioner | 526 Yale Ave N Apt 402, Seattle, WA 98109-5544 | 2020-10-01 |
| 1740896927 | Maia Zink | Nurse Practitioner | 10837 E Riverside Dr Apt C, Bothell, WA 98011-6123 | 2020-09-22 |
| 1760098339 | Yunyun Lu | Nurse Practitioner | 4922 51st Avenue Ct W, University Place, WA 98467-4828 | 2020-09-19 |
| 1255944278 | Alexis Leanne Snyder | Nurse Practitioner | 717 S 51st St, Tacoma, WA 98408-5710 | 2020-08-28 |
| 1841800521 | Lauren Levesque | Nurse Practitioner | 2744 Ne 54th St Unit B, Seattle, WA 98105-3146 | 2020-08-06 |
| Find all providers with the same taxonomy | ||||
| City | MOSES LAKE |
| Zip Code | 98837 |
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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.