MICHELLE E CLARK (NPI# 1295080141) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1295080141 |
| Entity Type | Individual |
| Full Name | MICHELLE E CLARK |
| Other Name | MICHELLE E BRINK |
| Credential | APRN |
| Practice Address |
24040 S Tamiami Trl Ste 202 Bonita Springs FL 34134-7040 |
| Practice Telephone | 2396240300 |
| Practice Fax Number | 2396240301 |
| Mailing Telephone | 2396240300 |
| Mailing Fax Number | 2396240301 |
| Enumeration Date | 2012-07-17 |
| Last Update Date | 2019-03-20 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
APRN9291822 | FL | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | MEDICARE | GI608Z | 01 |
| FL | BCBS | Y0C94 | 01 |
| FL | 006113900 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568078947 | Michelle Jean Clark | Counselor | 318 S Welborn St Ste C, Hinesville, GA 31313-3127 | 2020-09-21 |
| 1790335651 | Michelle Clark | Home Health Aide | 1794 E 87th St, Cleveland, OH 44106 | 2019-09-12 |
| 1215488168 | Michelle Allison Clark | Nurse Practitioner | 413 Glenbrook Rd, 9, Stamford, CT 06906-2126 | 2016-10-16 |
| 1174995120 | Michelle Annette Clark | Massage Therapist | 1935 S I St Apt A, Apt A, Tacoma, WA 98405-3879 | 2015-10-28 |
| 1518347095 | Michelle Marie Clark | Allergy & Immunology | 1600 Rockland Rd Ste 3d16, Wilmington, DE 19803 | 2015-06-01 |
| 1245620822 | Michelle Clark | Technician, Other | 715 Briar Hill Ln, Saginaw, MI 48609-5005 | 2015-02-03 |
| 1578987533 | Michelle Clark | Kinesiotherapist | 4573 Normandie Pl, La Mesa, CA 91942-8502 | 2014-02-12 |
| 1457624686 | Michelle Clark | Occupational Therapist | 6276 Jackie Ave, Woodland Hills, CA 91367-1422 | 2012-02-19 |
| 1922302967 | Michelle Clark | Occupational Therapist | 1930 Circle of Hope Dr Fl 2, Salt Lake City, UT 84132-0001 | 2011-01-05 |
| 1972813517 | Michelle Ann Clark | Marriage & Family Therapist | 10904 57th St Ne Ste 106, Albertville, MN 55301-4654 | 2010-10-18 |
| Street Address |
24040 S TAMIAMI TRL STE 202 |
| City | BONITA SPRINGS |
| State | FL |
| Zip Code | 34134-7040 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275658536 | Mark D Mcallister | Family Medicine | 24040 S Tamiami Trl Ste 202, Bonita Springs, FL 34134-7040 | 2007-03-19 |
| 1124275896 | Gilberto Antonio Riveron | Family Medicine | 24040 S Tamiami Trl Ste 202, Bonita Springs, FL 34134-7040 | 2008-08-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255803706 | Sheila Mourick | Home Health | 3920 Via Del Ray, Suite 4, Bonita Springs, FL 34134 | 2018-12-21 |
| 1447702162 | Averie Bendana | Hearing Instrument Specialist | 15 8th St Suite B, Hoglund Family Hearing, Bonita Springs, FL 34134 | 2016-10-28 |
| 1366990830 | Jordania Psychiatry LLC | Clinic/Center | 25111 Pennyroyal Dr, Bonita Springs, FL 34134 | 2016-09-14 |
| 1447682497 | Shancy Varghese Kanacheril | Pharmacist | 25121 S. Tamiami Trail, Bonita Springs, FL 34134 | 2013-08-01 |
| 1861762163 | Alyssa Haraczy | Pharmacist | 25121 S. Tamiami Trl, Bonita Springs, FL 34134 | 2012-01-04 |
| 1982905659 | Jessica Ann Rosen | Speech-Language Pathologist | 3384 Woods Edge Cir Ste 104, Bonita Springs, FL 34134 | 2010-11-10 |
| 1902116718 | Keenan Chiropractic Pa | Chiropractor | 3388 Woods Edge Circle Suite 102, Bonita Springs, FL 34134 | 2010-10-14 |
| 1659683076 | Amy Marie Mcneal | Massage Therapist | 28811 S. Tamiami Trail Unit 13-14, Bonita Springs, FL 34134 | 2010-07-14 |
| 1740509157 | Sarah Churton | Dermatology | 23471 Walden Center Drive, Suite 300, Bonita Springs, FL 34134 | 2010-05-25 |
| 1609003516 | Ram Prasad Kafle | Family Medicine | 26800 S Tamiami Trl Ste 340, Bonita Springs, FL 34134 | 2009-06-18 |
| Find all providers in zip 34134 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972154912 | Steffany Acovski | Nurse Practitioner | 4410 Vanda Dr, Bonita Springs, FL 34134-4082 | 2019-09-20 |
| 1225481005 | Sydney Tateo | Nurse Practitioner | 26800 Tamiami Trl, Suite 360, Bonita Springs, FL 34134-4349 | 2016-07-18 |
| 1649626409 | Jahaira Elizabeth Lasanta | Nurse Practitioner | 26649 Dublin Woods Cir, Bonita Springs, FL 34135-7224 | 2016-05-11 |
| 1821336694 | Caroline Smith | Nurse Practitioner | 9500 Bonita Beach Rd Se Ste 101, Bonita Springs, FL 34135-4679 | 2013-01-29 |
| 1205433687 | Malise Ann Novotny | Nurse Practitioner | 9776 Bonita Beach Rd Se, Bonita Springs, FL 34135-4773 | 2020-10-08 |
| 1699233312 | Malorie Nicole Saccomani | Nurse Practitioner | 27200 Imperial Pkwy, Bonita Springs, FL 34135-5801 | 2019-03-12 |
| 1164875936 | Skin Cancer Center of Naples LLC | Nurse Practitioner | 26800 S Tamiami Trl, Suite 360, Bonita Springs, FL 34134-4349 | 2016-07-18 |
| 1205243151 | Lauren Elizabeth Baptista | Nurse Practitioner | 8800 Terrene Ct, Suite #102, Bonita Springs, FL 34135-9530 | 2014-07-11 |
| 1427475722 | Marcanthony H Morgan | Nurse Practitioner | 9500 Bonita Beach Rd Se Ste 101, Bonita Springs, FL 34135-4679 | 2014-03-25 |
| 1619268547 | Erin Lake | Nurse Practitioner | 26800 S Tamiami Trl, Suite 340, Bonita Springs, FL 34134-4349 | 2011-04-26 |
| Find all providers in BONITA SPRINGS | ||||
| City | BONITA SPRINGS |
| Zip Code | 34134 |
Please comment or provide details below to improve the information on MICHELLE E 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.