DEBRA CLARK


Address: 1040 Vinehaven Dr Ne, Concord, NC 28025-2438
Phone: 7047841010

DEBRA CLARK (NPI# 1336525625) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1336525625
Entity Type Individual
Full Name DEBRA CLARK
Credential PNP
Practice Address 1040 Vinehaven Dr Ne
Concord
NC 28025-2438
Practice Telephone 7047841010
Practice Fax Number 7047841013
Mailing Telephone (704) 784-1010
Mailing Fax Number 7047841013
Enumeration Date 2015-08-10
Last Update Date 2017-06-23
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 363LP0200X Nurse Practitioner
Specialization: Pediatrics
5007863 NC Physician Assistants & Advanced Practice Nursing Providers

Other Provider Identifier

State Issuer Identifier Type Code
NC 1336525625 05

Other Providers DEBRA CLARK

NPI Name Taxonomy Address Enumeration
1255683330 Debra Ashley Clark Audiologist 1720 Peachtree St Nw Ste 200, Atlanta, GA 30309-2440 2012-10-12
1871816041 Debra Striler Clark Psychologist 71 Walnut, Suite 109, Rochester, MI 48307-2073 2010-03-02
1952539785 Debra Diane Clark Reflexologist 104 53rd Ave E, Bradenton, FL 34203-4702 2009-07-01
1720178650 Debra Sue Clark Physical Therapist 3500 S Boulevard, Suite A, Edmond, OK 73013-5490 2006-10-13
1609896943 Debra Jean Clark Counselor 10 Market St, Suite 5, Oneonta, NY 13820-2655 2006-07-20
1962473397 Debra Clark Family Medicine 1409 Rt 9, Keeseville, NY 12944-2845 2006-02-01
1154665669 Debra Mae Clark Physical Therapy Assistant 1502 E Centennial Dr, Pittsburg, KS 66762-6718 2012-11-21
1407144215 Debra Lou Clark Counselor 3 Bridge St, Carthage, NY 13619-1353 2011-07-13
1790003218 Debra Lynn Ann Clark Licensed Practical Nurse 116 Second St, Greenland, MI 49929 2010-05-07
1437477080 Debra E Clark Psychologist 110 N Cayuga St, Ithaca, NY 14850-4326 2010-05-06

Office Location

Street Address 1040 VINEHAVEN DR NE
City CONCORD
State NC
Zip Code 28025-2438

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1053910729 Renewed Mindset Therapeutic Services, Pllc Social Worker 349 Copperfield Blvd Suite L #334, Concord, NC 28025 2020-10-22
1194284380 Carolinas Physicians Network Inc Internal Medicine 610 Alfred Brown Jr. Court, Concord, NC 28025 2019-03-18
1164913596 Damarius Raymond Faggart Counselor 503 Amhurst Drive, Concord, NC 28025 2018-05-22
1437677085 Kathryn Emily Kanauer Counselor 280 Executive Park Dr Ne, Concord, NC 28025 2017-09-05
1649794439 Foster Health & Homecare, LLC Home Health 363 Church Street North, Suite 260-i, Concord, NC 28025 2017-08-02
1326569336 Jessie Leigh Tilley-compton Social Worker 371 Amhurst St Sw, Concord, NC 28025 2017-06-29
1609305663 Sarah Katherine Thompson Licensed Practical Nurse 248 Executive Park Dr, Concord, NC 28025 2017-06-05
1023463098 Kiera Brown Social Worker 219 Lephillip Court, Concord, NC 28025 2016-04-27
1992169445 Brittiny N. Ingram Vanterpool Counselor 250 Branchview Dr Sw, Concord, NC 28025 2016-04-11
1215399852 The Charlotte-mecklenburg Hospital Authority Clinic/Center 840 Warren C. Coleman Blvd, Concord, NC 28025 2016-03-23
Find all providers in zip 28025

Taxonomy Information

Taxonomy Code 363LP0200X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Nurse Practitioner
Specialization Pediatrics

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1740534551 Meaghan Elise Pugh Nurse Practitioner 2165 East St, Concord, CA 94520-2011 2012-10-31
1831679752 Amelia Michal Sperber Nurse Practitioner 2165 East St, Concord, CA 94520-2011 2018-08-20
1831677046 Lindsay M Benton Nurse Practitioner 253 Pleasant St, Pediatrics, Concord, NH 03301-7560 2018-07-31
1770955445 Meghan Chase Nurse Practitioner 330 Baker Ave, Pediatrics, Concord, MA 01742-2129 2015-10-21
1336529007 Erin Winters Davis Nurse Practitioner 100 Medical Park Dr, Suite 310, Concord, NC 28025-2948 2015-06-08
1104242148 Nicole Marie Demaria Nurse Practitioner 330 Baker Ave, Concord, MA 01742-2129 2014-03-14
1235467598 Jessie Catherine Taylor Nurse Practitioner 133 Ornac, Emerson Hospital Pediatric Dept., Concord, MA 01742-4159 2009-11-25
1922240779 Christine Mayor Nurse Practitioner 2299 Bacon St Ste 7, Concord, CA 94520-2046 2009-03-25
1730354515 Nancy P Mizzoni Nurse Practitioner 131 Old Road To 9 Acre Cor, Suite 470, Concord, MA 01742-4181 2008-04-23
1780702191 Colleen M Hibbert Nurse Practitioner 1040 Vinehaven Drive, Concord, NC 28025-2438 2007-03-26
Find all providers in CONCORD

Competitor

Search similar providers

City CONCORD
Zip Code 28025

Improve Information

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Dataset Information

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.

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