DEBRA CLARK (NPI# 1336525625) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
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 |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 363LP0200X |
Nurse Practitioner Specialization: Pediatrics |
5007863 | NC | Physician Assistants & Advanced Practice Nursing Providers |
State | Issuer | Identifier | Type Code |
---|---|---|---|
NC | 1336525625 | 05 |
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 |
Street Address |
1040 VINEHAVEN DR NE |
City | CONCORD |
State | NC |
Zip Code | 28025-2438 |
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 Code | 363LP0200X |
Grouping | Physician Assistants & Advanced Practice Nursing Providers |
Classification | Nurse Practitioner |
Specialization | Pediatrics |
Definition to come... |
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 |
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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.