MS. SUSAN MARIE CLARK (NPI# 1326055534) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1326055534 |
| Entity Type | Individual |
| Full Name | MS. SUSAN MARIE CLARK |
| Credential | C.R.N.P. |
| Practice Address |
301 Randolph St Denton MD 21629-1243 |
| Practice Telephone | 4104794306 |
| Practice Fax Number | 4104791714 |
| Mailing Telephone | 4104794306 |
| Mailing Fax Number | 4104791714 |
| Enumeration Date | 2006-08-01 |
| Last Update Date | 2008-06-30 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
R157798 | MD | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MD | COVENTRY | 521116591 | 01 |
| MD | TRICARE | 521116591 | 01 |
| MD | INFORMED | 521116591 | 01 |
| CIGNA | 9924498 | 01 | |
| MD | CF BC/BS GRP/GHMSI/BL CHO | T5880040 | 01 |
| MD | 784381000 | 05 | |
| MD | CAREFIRST BC/BS RENDERING | 89583301 | 01 |
| NCPPO | 766408 | 01 | |
| PRIORITY PARTNERS | 207884 | 01 | |
| MD | MARYLAND PHYSICIANS CARE | 521116591 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376161950 | Susan Marie Clark | Nurse Practitioner | 674 Coral Way, Winter Springs, FL 32708-3127 | 2020-07-09 |
| 1528591575 | Susan Clark | Counselor | 604 S Walnut, Stillwater, OK 74074-4222 | 2017-04-06 |
| 1790178556 | Susan March Clark | Peer Specialist | 3277 E 2nd St, Tulsa, OK 74104-2134 | 2015-03-17 |
| 1841537990 | Susan Noble Clark | Developmental Therapist | 1730 Radcliffe Rd, Montgomery, AL 36106-2620 | 2013-01-09 |
| 1881963411 | Susan Clark | Occupational Therapy Assistant | 38 Wheeler Ave, Warwick, NY 10990-1341 | 2011-12-28 |
| 1437302684 | Susan Maslin Clark | Chiropractor | 20416 Bowfonds St, Ashburn, VA 20147-7457 | 2008-11-01 |
| 1871780940 | Susan Marie Clark | Counselor | 112 S Water St Ste B, Kent, OH 44240-3689 | 2007-10-02 |
| 1750403861 | Susan M Clark | Psychologist | 1022 Cherokee Ave, Royal Oak, MI 48067 | 2007-04-06 |
| 1598892085 | Susan L Clark | Psychiatry & Neurology | 9515 60th Ave W, Mukilteo, WA 98275 | 2007-02-28 |
| 1609968692 | Susan M Clark | Pediatrics | 1318 S Main Road, Vineland, NJ 08360 | 2006-09-28 |
| Street Address |
301 RANDOLPH ST |
| City | DENTON |
| State | MD |
| Zip Code | 21629-1243 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477531077 | Sue Ellen Hagie | Nurse Practitioner | 301 Randolph St, Denton, MD 21629-1243 | 2006-01-04 |
| 1568847911 | Choptank Community Health System, Inc. | Clinic/Center | 301 Randolph St, Denton, MD 21629-1243 | 2015-07-28 |
| 1043568033 | Rodshekia Denise Newton | Dental Hygienist | 301 Randolph St, Denton, MD 21629-1243 | 2012-08-22 |
| 1164647798 | Lorraine Hall-pfaff | Dental Hygienist | 301 Randolph St, Denton, MD 21629 | 2007-04-17 |
| 1063533487 | Trudy J Dean | Dental Hygienist | 301 Randolph St, Denton, MD 21629-1243 | 2007-04-03 |
| 1538298070 | Choptank Community Health System, Inc. | Clinic/Center | 301 Randolph St, Denton, MD 21629-1243 | 2007-03-02 |
| 1881736163 | Jean Theresa Holtz | Dental Hygienist | 301 Randolph St, Denton, MD 21629-1243 | 2007-02-13 |
| 1356388599 | Choptank Community Health System Inc | Clinic/Center | 301 Randolph St, Denton, MD 21629-1243 | 2006-05-31 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518423060 | Marilyn Serino | Social Worker | 207 South 7th Street, Denton, MD 21629 | 2019-02-20 |
| 1699246421 | Jody Lynn Wagner | Speech-Language Pathologist | 204 Market Street, Denton, MD 21629 | 2018-12-05 |
| 1487136404 | Thomas J. Yoder | Physical Therapist | 103 South 7th Street, Denton, MD 21629 | 2018-09-06 |
| 1821512773 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 21 Denton Plz, Denton, MD 21629 | 2017-08-02 |
| 1548708803 | Board of Child Care of The Umc Inc | Community/Behavioral Health | 27993 Substation Rd, Denton, MD 21629 | 2017-02-07 |
| 1598219156 | Deanna Mcmullen | Physical Therapist | 1140 Blades Farm Rd Ste 201, Denton, MD 21629 | 2016-08-11 |
| 1538574314 | Medha Satyarengga | Internal Medicine | 1140 Blades Farm Rd Ste 101, Denton, MD 21629 | 2014-06-30 |
| 1104147586 | Kimberly Schall | Physical Therapist | 103 S. 7th Steet, Denton, MD 21629 | 2010-06-19 |
| 1891926978 | Choptank Community Health System, Inc. | Clinic/Center | 401 Lockerman St, Denton, MD 21629 | 2009-08-06 |
| 1285896951 | Carolyn F. Witt | Social Worker | 606 Sunnyside St., Denton, MD 21629 | 2008-06-25 |
| Find all providers in zip 21629 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124629639 | Tania Castleman | Nurse Practitioner | 2028 Chandler Dr, Denton, TX 76209-1616 | 2020-11-03 |
| 1487251765 | Anna Rose Beccone | Nurse Practitioner | 3537 S I 35 E Ste 317, Denton, TX 76210-6870 | 2020-10-08 |
| 1316566599 | Heather Ashley Medaris | Nurse Practitioner | 2800 Frontier Dr, Denton, TX 76210-1200 | 2020-04-08 |
| 1124662028 | Kyle David Motsenbocker | Nurse Practitioner | 2700 Cedar Creek Ln Apt 1226, Denton, TX 76210-2110 | 2019-11-04 |
| 1780148783 | Cassandra Jeanette Gutierrez | Nurse Practitioner | 1119 Collier St Ste 100, Denton, TX 76201-6579 | 2019-01-24 |
| 1679043095 | Yasmin Lakhani | Nurse Practitioner | 2501 Scripture St Ste 103, Denton, TX 76201-2314 | 2018-11-28 |
| 1750879565 | Abisola Abosede | Nurse Practitioner | 1201 Bayfield St, Denton, TX 76209-3547 | 2018-04-26 |
| 1124529490 | Maria Tranquilina Jimenez | Nurse Practitioner | 4206 S Interstate 35 E, Denton, TX 76207 | 2018-02-22 |
| 1477067387 | Jaime Elizabeth Mendez | Nurse Practitioner | 209 N Bonnie Brae St Ste 203, Denton, TX 76201-3748 | 2017-11-30 |
| 1861919144 | Mary Lenore Garcia | Nurse Practitioner | 2435 W. Oak St., Suite 103, Denton, TX 76201 | 2017-08-28 |
| Find all providers in DENTON | ||||
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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.