NICOLE CLARK (NPI# 1386106375) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1386106375 |
| Entity Type | Individual |
| Full Name | NICOLE CLARK |
| Credential | HAIR LOSS SPECIALIST |
| Practice Address |
100 N Burke Ave Long Beach MS 39560-4605 |
| Practice Telephone | 2282341658 |
| Mailing Telephone | 2282341658 |
| Enumeration Date | 2019-04-01 |
| Last Update Date | 2019-04-01 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 224P00000X | Prosthetist | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396344826 | Nicole Clark | Home Health Aide | 1024 E 26th Ave, Columbus, OH 43211-2127 | 2020-10-26 |
| 1023513637 | Nicole Elizabeth Clark | Counselor | 3650 Ne Mallory Ave Apt 309, Portland, OR 97212-3086 | 2018-03-26 |
| 1619486834 | Nicole Clark | Registered Nurse | N4093 Keehn Rd, Winter, WI 54896-7312 | 2017-09-20 |
| 1285182022 | Nicole Michelle Clark | Social Worker | 1349 East Stroop Road, Dayton, OH 45429-4925 | 2016-09-21 |
| 1871968768 | Nicole Clark | Specialist/Technologist | 332 Wilson Dr, Bloomfield, IN 47424-1054 | 2015-12-03 |
| 1598165144 | Nicole Janine Clark | Behavioral Analyst | 1787 Village Ln N, Wantagh, NY 11793-3228 | 2014-09-02 |
| 1841609484 | Nicole Tm Clark | Emergency Medicine | 267 Ocean Ave, Portland, ME 04103-5707 | 2014-08-07 |
| 1851445670 | Nicole Ann Clark | Social Worker | 2051 S State St, Ann Arbor, MI 48104-4607 | 2007-01-22 |
| 1982767604 | Nicole Christine Clark | Licensed Practical Nurse | 241 Lorraine Ave, Syracuse, NY 13210-3229 | 2006-12-18 |
| 1760598411 | Nicole Anne Clark | Family Medicine | 475 W 940 N, Provo, UT 84604-3301 | 2006-08-22 |
| Street Address |
100 N BURKE AVE |
| City | LONG BEACH |
| State | MS |
| Zip Code | 39560-4605 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336660786 | Vitas Laboratory LLC | Clinical Medical Laboratory | 2048 Pineville Road, Suite B, Long Beach, MS 39560 | 2017-07-06 |
| 1760889554 | Laura Catherine Ranson | Physical Therapist | 2 Tower Plaz, Suite B, Community Rehab Center, Long Beach, MS 39560 | 2014-11-24 |
| 1073803714 | Kathleen Ann Williams | Pharmacist | Riteaid #7227 Pharmacy 200 West Railroad St, Suite B, Long Beach, MS 39560 | 2011-04-14 |
| 1609177179 | Robert William Wylie | Hearing Instrument Specialist | 100 Larosa Rd, Ste D, Long Beach, MS 39560 | 2010-11-15 |
| 1891026498 | James Paul Bertinato | Speech-Language Pathologist | 20337 Longview Rd, Long Beach, MS 39560 | 2010-01-21 |
| 1639317274 | Robert A Wiemer Jr. | Pain Medicine | 528-f Klondike Road, Long Beach, MS 39560 | 2009-02-03 |
| 1932362324 | Family Physical Therapy of South Ms LLC | Physical Therapist | 100-a La Rosa Rd, Long Beach, MS 39560 | 2008-07-07 |
| 1952589863 | Miller-whitmer Family Chiropractic | Chiropractor | 125 Jeff Davis Avenue, Long Beach, MS 39560 | 2008-02-01 |
| 1528267333 | Rachel S Conrad Md PC | Family Medicine | 100a Larosa, Long Beach, MS 39560 | 2007-07-12 |
| 1386720241 | Betty Diane Edrington | Registered Nurse | 2 Tower Plaza, Pineville Road, Long Beach, MS 39560 | 2006-10-31 |
| Find all providers in zip 39560 | ||||
| Taxonomy Code | 224P00000X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Prosthetist |
| A health care professional who is specifically educated and trained to manage comprehensive prosthetic patient care for individuals who have sustained complete or partial limb loss or absence. Prosthetists assess specific patient needs, formulate an appropriate treatment plan, implement the treatment plan and provide follow-up care. |
| Notes: Source: American Board for Certification in Orthotics, Prosthetics, and Pedorthics, Inc. [7/1/2010: modified, 7/1/2013: modified] Additional Resources: American Board for Certification in Orthotics, Prosthetics and Pedorthics, Inc., www.abcop.org and Board of Certification/Accreditation, International, www.bocusa.org. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154895944 | Keyonia K Paramore | Prosthetist | 735 W Pacific Coast Hwy, Long Beach, CA 90806-5240 | 2019-01-15 |
| 1659804144 | Laverne Thomas | Prosthetist | 4148 Norse Way, Long Beach, CA 90808-1533 | 2017-04-11 |
| 1801084843 | Chandra S Mohanty | Prosthetist | 1043 Elm Ave Ste 202, Long Beach, CA 90813-3244 | 2007-10-03 |
| 1184812125 | Mark A Conry | Prosthetist | 1043 Elm Ave Ste 202, Long Beach, CA 90813-3244 | 2007-10-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285247783 | Jay Michael Rubenstein | Prosthetist | 3004 Bienville Blvd Ste 1, Ocean Springs, MS 39564-4370 | 2020-08-25 |
| 1750906301 | Denisha Louise Williams | Prosthetist | 828 Pass Rd Ste C, Gulfport, MS 39501-6437 | 2020-06-10 |
| 1538795364 | Faithful Limbs Prosthetics | Prosthetist | 114 Herring Dr, Raymond, MS 39154-9646 | 2020-03-12 |
| 1801428438 | Kimberly Toler | Prosthetist | 8225 Barberry Pl, Southaven, MS 38671-4203 | 2020-02-11 |
| 1194287953 | Brianna Marshall | Prosthetist | 100 Shelby Street, Beulah, MS 38726 | 2019-04-02 |
| 1023576972 | Synterika Shanta Welch | Prosthetist | 7164 Hacks Cross Rd, Olive Branch, MS 38654-4472 | 2019-03-11 |
| 1295203602 | Joanetta Marie Williams | Prosthetist | 806 S 28th Ave, Hattiesburg, MS 39402-2601 | 2018-11-05 |
| 1174888457 | Philip Anthony Bickert | Prosthetist | 2106s Tate St, Corinth, MS 38834-7913 | 2012-07-12 |
| 1194909069 | Richard C Boleware | Prosthetist | 2 Old River Pl Ste D, Jackson, MS 39202-3435 | 2007-12-27 |
| 1285848846 | Douglas Santrell Banks | Prosthetist | 199 Charmant Pl, Suite 4, Ridgeland, MS 39157-4358 | 2007-05-10 |
| Find all providers with the same taxonomy | ||||
| City | LONG BEACH |
| Zip Code | 39560 |
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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.