LISA LYNN CLARK (NPI# 1336100130) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1336100130 |
| Entity Type | Individual |
| Full Name | LISA LYNN CLARK |
| Credential | CRNA |
| Practice Address |
4370 W Main Street Dothan AL 36305 |
| Mailing Address |
Po Box 6907 Dothan AL 36302 |
| Practice Telephone | 3347935000 |
| Practice Fax Number | 3346158428 |
| Mailing Telephone | 3347935000 |
| Mailing Fax Number | 3346158428 |
| Enumeration Date | 2006-03-31 |
| Last Update Date | 2011-07-25 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 367500000X | Nurse Anesthetist, Certified Registered | 1054427 | AL | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | 000652451B | 05 | |
| AL | 051515740 | 05 | |
| FL | 301239500 | 05 | |
| AL | BLUE CROSS BLUE SHIELD | 51515740 | 01 |
| RR MEDICARE | P00078968 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154776912 | Lisa Clark | Counselor | 8722 Heaton St, New Orleans, LA 70118-2616 | 2016-04-29 |
| 1548694383 | Lisa G Clark | Speech-Language Pathologist | 2405 Champaign Ave, Mattoon, IL 61938-2646 | 2013-08-28 |
| 1073857801 | Lisa Ann Clark | Specialist | 1110 Chenango St, Binghamton, NY 13901-1668 | 2012-11-16 |
| 1952680324 | Lisa S Clark | Counselor | 1223 Meadow Lake Rd, Rockledge, FL 32955-8403 | 2011-08-16 |
| 1134456445 | Lisa Lynn Clark | Occupational Therapist | 85 Lunt Rd, Brunswick, ME 04011-7289 | 2009-11-06 |
| 1437485836 | Lisa Landers Clark | Counselor | 1 Waterford Ln, Savannah, GA 31411-1305 | 2009-10-20 |
| 1710146220 | Lisa M Clark | Nurse Practitioner | University Hosp Medical Center Stony Brk, Dept Pediatrics Hsc 11th Floor, Stony Brook, NY 11794-0001 | 2008-06-09 |
| 1376742841 | Lisa M Clark | Specialist | 4308 N 26th St, Tacoma, WA 98407-5211 | 2007-07-15 |
| 1356453260 | Lisa M Clark | Dentist | Bonham Family Dentistry, 101 E 9th Street, Bonham, TX 75418 | 2006-08-31 |
| 1598779100 | Lisa Bardy Clark | Family Medicine | 12815 Highway 98 West, Suite 116, Destin, FL 32550 | 2006-07-28 |
| Street Address |
4370 W MAIN STREET |
| City | DOTHAN |
| State | AL |
| Zip Code | 36305 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871560599 | Daniel Leon Turley | Emergency Medicine | 4370 W Main Street, Dothan, AL 36305 | 2006-03-01 |
| 1790740843 | Shirley Ann Skinner | Nurse Anesthetist, Certified Registered | 4370 W Main Street, Dothan, AL 36305 | 2006-04-20 |
| 1699736496 | Wilma J Watt | Nurse Anesthetist, Certified Registered | 4370 W Main Street, Dothan, AL 36305 | 2006-03-31 |
| 1477514271 | Freda Wynell Stewart | Nurse Anesthetist, Certified Registered | 4370 W Main Street, Dothan, AL 36305 | 2006-03-31 |
| 1790746592 | Catherine Ann Orr | Nurse Anesthetist, Certified Registered | 4370 W Main Street, Dothan, AL 36305 | 2006-03-31 |
| 1629039458 | Belinda Gail Garzarek | Nurse Anesthetist, Certified Registered | 4370 W Main Street, Dothan, AL 36305 | 2006-03-31 |
| 1578524328 | Charles Steven Chancey | Nurse Anesthetist, Certified Registered | 4370 W Main Street, Dothan, AL 36305 | 2006-03-31 |
| 1467413229 | John Cleveland Miller Jr. | Nurse Anesthetist, Certified Registered | 4370 W Main Street, Dothan, AL 36305 | 2006-03-31 |
| 1891756714 | Christina Irene Pearson | Nurse Anesthetist, Certified Registered | 4370 W Main Street, Dothan, AL 36305 | 2006-03-30 |
| 1407817331 | Pamela Susan Averett | Nurse Anesthetist, Certified Registered | 4370 W Main Street, Dothan, AL 36305 | 2006-03-30 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962059998 | Samantha Nicole Bolden | Counselor | 1001 John D. Odom Road, Dothan, AL 36305 | 2019-08-23 |
| 1578968780 | Aba Therapy & Consulting Services | Behavioral Analyst | 3124 West Main Street, Suite 9, Dothan, AL 36305 | 2014-10-30 |
| 1306247796 | Tracey Lynn Carter | Registered Nurse | 4300 W Main St Ste 102, Dothan, AL 36305 | 2014-09-04 |
| 1760829881 | Michael Brent Nance | Nurse Practitioner | 4370 West Main Street, Dothan, AL 36305 | 2013-05-30 |
| 1033495221 | Professional Resource Management of Wiregrass, LLC | Psychiatry & Neurology | 2812 Hartford Hwy Ste 1, Dothan, AL 36305 | 2011-11-01 |
| 1649555483 | Ashley Dawn Morrow | Pharmacist | 2940 West Main Street, Dothan, AL 36305 | 2011-10-12 |
| 1740599273 | Aline M Mays-easley | Counselor | 309 Ameris Ave, Dothan, AL 36305 | 2010-10-01 |
| 1356671408 | Kimberly Jones Rogers | Clinical Neuropsychologist | 200 Grove Park Ln Ste 212, Dothan, AL 36305 | 2010-01-12 |
| 1639347818 | Southeast Alabama Counseling & Behavioral Specialist | Residential Treatment Facility, Emotionally Disturbed Children | 407 Honeysuckle Rd Ste 207, Dothan, AL 36305 | 2008-02-11 |
| 1770705667 | Michala Long | Pharmacist | 3850 West Main St, Dothan, AL 36305 | 2007-05-02 |
| Find all providers in zip 36305 | ||||
| Taxonomy Code | 367500000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Anesthetist, Certified Registered |
| (1) A licensed registered nurse with advanced specialty education in anesthesia who, in collaboration with appropriate health care professionals, provides preoperative, intraoperative, and postoperative care to patients and assists in management and resuscitation of critical patients in intensive care, coronary care, and emergency situations. Nurse anesthetists are certified following successful completion of credentials and state licensure review and a national examination directed by the Council on Certification of Nurse Anesthetists. (2) A registered nurse who is qualified by special training to administer anesthesia in collaboration with a physician or dentist and who can assist in the care of patients who are in critical condition. |
| Notes: Sources: (1) Council on Certification of Nurse Anesthetists, Park Ridge, IL, and Rhea, Ott, and Shafritz, The Facts On File Dictionary of Health Care Management, New York: Facts On File Publications, 1988. (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. 548. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073663589 | William G Smith Jr. | Nurse Anesthetist, Certified Registered | 103 Nottoway Blvd, Dothan, AL 36303-2979 | 2007-01-10 |
| 1720026891 | Linda S. Brock | Nurse Anesthetist, Certified Registered | 36 Hampton Way, Dothan, AL 36305-6319 | 2006-06-02 |
| 1801875620 | James A Kennedy | Nurse Anesthetist, Certified Registered | 2802 Ross Clark Circle, Dothan, AL 36301 | 2006-01-11 |
| 1861471732 | Alice M Hickey | Nurse Anesthetist, Certified Registered | 1450 Ross Clark Circle, Dothan, AL 36301 | 2006-01-10 |
| 1871114090 | Hillary Ryan Mclemore | Nurse Anesthetist, Certified Registered | 4370 W Main St, Dothan, AL 36305-4000 | 2020-04-28 |
| 1659990901 | Robert Dale Garrett | Nurse Anesthetist, Certified Registered | 1108 Ross Clark Cir, Dothan, AL 36301-3022 | 2020-04-15 |
| 1972076859 | Tillman Hall | Nurse Anesthetist, Certified Registered | 4370 W Main St, Dothan, AL 36305-1056 | 2019-01-03 |
| 1023525169 | Michael Aaron Allen | Nurse Anesthetist, Certified Registered | 4370 W Main St, Dothan, AL 36305-1056 | 2018-01-09 |
| 1508373143 | Derek Austin Dean | Nurse Anesthetist, Certified Registered | 4370 W Main St, Dothan, AL 36305-1056 | 2018-01-04 |
| 1790201903 | Gut PC | Nurse Anesthetist, Certified Registered | 1450 Ross Clark Cir Ste 400, Dothan, AL 36301-4770 | 2017-08-18 |
| Find all providers in DOTHAN | ||||
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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.