MRS. TERESA M CLARK (NPI# 1306956172) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1306956172 |
| Entity Type | Individual |
| Full Name | MRS. TERESA M CLARK |
| Credential | CRNP |
| Practice Address |
340 Montage Mountain Rd Moosic PA 18507-1782 |
| Practice Telephone | 5703463686 |
| Practice Fax Number | 5705586838 |
| Mailing Telephone | 5703463686 |
| Mailing Fax Number | 5705586838 |
| Enumeration Date | 2006-08-30 |
| Last Update Date | 2010-09-02 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363L00000X | Nurse Practitioner | TP006932B | PA | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144779778 | Teresa Clark | Contractor | 2304 W Gordon Ave Apt 218, Albany, GA 31707-4607 | 2016-09-23 |
| 1750624904 | Teresa Louise Clark | Licensed Vocational Nurse | 2121 E 1st St, 306, Long Beach, CA 90803-2418 | 2013-04-05 |
| 1538373337 | Teresa Clark | Counselor | 721 Bath Rd, Wiscasset, ME 04578-4830 | 2007-05-10 |
| 1689759516 | Teresa Marie Clark | Dental Assistant | 7218 Birch Bark Drive, Fairview, TN 37062 | 2006-10-26 |
| 1538194261 | Teresa Elaine Clark | Internal Medicine | 2920 S Pharr Ct Nw, Atlanta, GA 30305-2104 | 2006-07-11 |
| 1407827561 | Teresa Jean Clark | Physical Therapist | 40900 Merchants Lane, Suite 202, Leonardtown, MD 20650 | 2006-01-27 |
| 1962931733 | Teresa Octavia Clark | Case Manager/Care Coordinator | 9403 Mansfield Rd, Shreveport, LA 71118-3815 | 2017-06-06 |
| 1235585563 | Teresa A Clark | Nurse Practitioner | 4800 E Johnson Ave, Jonesboro, AR 72401-8413 | 2016-05-05 |
| 1912307109 | Teresa M Clark | Occupational Therapist | 301 Highway 65 S, Mora, MN 55051-1899 | 2014-08-26 |
| 1871853622 | Teresa Sha Clark | Social Worker | 700 Childrens Dr, Clinical Services and Care Coordination, Columbus, OH 43205-2664 | 2012-05-25 |
| Street Address |
340 MONTAGE MOUNTAIN RD |
| City | MOOSIC |
| State | PA |
| Zip Code | 18507-1782 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295718237 | Matthew Adam Berger | Psychiatry & Neurology | 340 Montage Mountain Rd, Moosic, PA 18507-1782 | 2005-11-23 |
| 1396367892 | Monica Stroz | Nurse Practitioner | 340 Montage Mountain Rd, Moosic, PA 18507-1707 | 2020-05-07 |
| 1275178626 | Megan Marie Birk | Counselor | 340 Montage Mountain Rd, Moosic, PA 18507-1707 | 2019-11-08 |
| 1942844329 | Samantha Cummins | Physician Assistant | 340 Montage Mountain Rd, Moosic, PA 18507-1707 | 2019-10-29 |
| 1891336244 | Colleen Flynn Ries | Nurse Practitioner | 340 Montage Mountain Rd, Moosic, PA 18507-1707 | 2019-10-07 |
| 1235798240 | Amanda Leigh Craven | Nurse Practitioner | 340 Montage Mountain Rd, Moosic, PA 18507-1707 | 2019-06-12 |
| 1750949384 | Kelly A. Roughgarden | Counselor | 340 Montage Mountain Rd, Moosic, PA 18507-1707 | 2019-05-29 |
| 1760941462 | Wendy Hall | Nurse Practitioner | 340 Montage Mountain Rd, Moosic, PA 18507-1707 | 2019-03-13 |
| 1063986313 | Marie T Zedalis | Nurse Practitioner | 340 Montage Mountain Rd, Moosic, PA 18507-1707 | 2019-01-18 |
| 1225509003 | Kyle L Strobel | Counselor | 340 Montage Mountain Rd, Moosic, PA 18507-1782 | 2018-12-05 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184270969 | Frances R Acker- Pisko | Massage Therapist | 540 Gleason Drive, Moosic, PA 18507 | 2019-08-16 |
| 1457854150 | Leanna Tabatabaie | Dietitian, Registered | 532 Main St Ste 3, Moosic, PA 18507 | 2018-03-09 |
| 1689092769 | James Vito Squadrito Jr. | Physical Therapist | 3356 Birney Plaza, Pro Rehabilitation Services, Moosic, PA 18507 | 2014-04-04 |
| 1871881573 | Ethical Factor Rx LLC | Durable Medical Equipment & Medical Supplies | 4213 Birney Ave, Suite 4, Moosic, PA 18507 | 2011-07-14 |
| 1508955725 | Edward Christopher Grambo | Dentist | 3812 Birney Ave, Moosic, PA 18507 | 2006-10-12 |
| 1316044431 | Moosic Dental Group Inc | Dentist | 502 Church Street, Moosic, PA 18507 | 2006-09-20 |
| 1528047347 | Ralph Demario | Internal Medicine | 340 Momtage Mt Road, Moosic, PA 18507 | 2006-01-11 |
| 1023658895 | Ichs Corporatioin | Clinic/Center | 73 Montage Mountain Road, Moosic, PA 18507 | 2020-01-09 |
| 1285012526 | Laura Herbener | Nurse Practitioner | 53 Glenmaura National Blvd, Moosic, PA 18507 | 2015-05-06 |
| 1104266824 | Travis Edward Perry | Dentist | 502 Church Street, Moosic, PA 18507 | 2013-06-26 |
| Find all providers in zip 18507 | ||||
| Taxonomy Code | 363L00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners. |
| Notes: Source: (1) American Nurses’ Association, American Nurses Credentialing Center, 1996 Certification Catalogue. (2) ) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 549. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245668177 | Lula Thomas | Nurse Practitioner | 340 Montage Mountain Rd, Moosic, PA 18507-1782 | 2013-11-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326648320 | Jennifer Glace | Nurse Practitioner | 5 Moore Cir, Media, PA 19063-4953 | 2020-10-28 |
| 1710586805 | Tracey Wuestkamp Sloan | Nurse Practitioner | 5218 Bailey Ct W, Doylestown, PA 18902-1477 | 2020-10-20 |
| 1477151280 | Kelly M. Distelrath | Nurse Practitioner | 4203 Timberlane Dr, Allison Park, PA 15101-2954 | 2020-10-14 |
| 1538766837 | Kimberly Ann Martyn | Nurse Practitioner | 168 W Baltimore Pike, Media, PA 19063 | 2020-10-08 |
| 1679170989 | Aubree Marie Richards | Nurse Practitioner | 253 N Hershey Rd Ste 2, Harrisburg, PA 17112-9752 | 2020-10-08 |
| 1326654237 | Alissa Marie Buckanavage | Nurse Practitioner | 6223 Autumn View Dr, Harrisburg, PA 17112-1843 | 2020-09-17 |
| 1508471962 | Macey Schaffer | Nurse Practitioner | 2903 Broadway Ave, Pittsburgh, PA 15234-2801 | 2020-09-12 |
| 1710592472 | Novique Medical Aesthetics | Nurse Practitioner | 1715 S Easton Rd, Doylestown, PA 18901-5923 | 2020-09-10 |
| 1992318141 | Mary Jucel P Angeles | Nurse Practitioner | 100 E Lancaster Ave Ste 467, Wynnewood, PA 19096-3434 | 2020-08-27 |
| 1205448818 | Emily A Lockwood | Nurse Practitioner | 266 Lancaster Ave Ste 303, Malvern, PA 19355-3256 | 2020-08-17 |
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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.