SAPPHIRA JO CLARK (NPI# 1407218902) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1407218902 |
| Entity Type | Individual |
| Full Name | SAPPHIRA JO CLARK |
| Credential | NP |
| Practice Address |
202 S John Redditt Dr Lufkin TX 75904-3112 |
| Practice Telephone | 9366391005 |
| Practice Fax Number | 9366398969 |
| Mailing Telephone | 9366391005 |
| Enumeration Date | 2016-03-23 |
| Last Update Date | 2016-03-23 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
AP130469 | TX | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
202 S JOHN REDDITT DR |
| City | LUFKIN |
| State | TX |
| Zip Code | 75904-3112 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245281971 | Andrew J Fercowicz | Family Medicine | 202 S John Redditt Dr, Lufkin, TX 75904-3112 | 2006-05-15 |
| 1396126371 | Marni S Rossman | Nurse Practitioner | 202 S John Redditt Dr, Lufkin, TX 75904-3112 | 2015-06-15 |
| 1063779866 | Andrew J. Fercowicz, M.d.,p.a. | Family Medicine | 202 S John Redditt Dr, Lufkin, TX 75904-3112 | 2012-04-18 |
| 1356461313 | Janet Fry | Nurse Practitioner | 202 S John Redditt Dr, Lufkin, TX 75904-3112 | 2007-03-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437759750 | David Kent Emmerling | Pharmacist | Walmart Pharmacy 10-0140, 2500 Daniel Mccall Drive, Lufkin, TX 75904 | 2020-10-27 |
| 1831732718 | Isaac Kwame Agyare | Pharmacist | 1522 West Frank Ave. Room 127, Lufkin, TX 75904 | 2019-10-23 |
| 1598314999 | Eva Faye Mcduffie | Technician | 1006 Sherwood Rd., Lufkin, TX 75904 | 2019-09-09 |
| 1477036119 | Tyra Williams | Occupational Therapy Assistant | 902 Hill Street, Lufkin, TX 75904 | 2018-09-10 |
| 1720560188 | Veronica Monique Kennedy | Pharmacist | 1522 West Frank, Lufkin, TX 75904 | 2018-09-02 |
| 1356821532 | Mark Anthony Plowman | Licensed Vocational Nurse | 379 Copperfield Loop, Lufkin, TX 75904 | 2018-08-17 |
| 1396222311 | Kevin Pulikottil Cherian | Occupational Therapist | 402 S John Redditt Dr., Lufkin, TX 75904 | 2018-07-23 |
| 1922593029 | Sarah Marie Stuart | Dentist | 103 N Brentwood Dr, Unit 400, Lufkin, TX 75904 | 2018-06-30 |
| 1083104004 | Pam Specialty Hospital of Lufkin, LLC | Long Term Care Hospital | 1201 W Frank Ave Ste D5, Lufkin, TX 75904 | 2018-05-15 |
| 1124523840 | Jane C Davidson | Nurse Practitioner | 1 Medical Center Blvd Ste C, Lufkin, TX 75904 | 2018-03-26 |
| Find all providers in zip 75904 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083212732 | Koshy Vellavoor Jose | Nurse Practitioner | 207 Heather St, Lufkin, TX 75904-4845 | 2020-10-14 |
| 1477169027 | Daniel Ray Baxter | Nurse Practitioner | 180 Plum Rdg, Lufkin, TX 75904-0480 | 2020-09-18 |
| 1114531902 | Stacey Michelle Youngblood | Nurse Practitioner | 1229 Old Ewing Rd, Lufkin, TX 75901-0729 | 2020-08-31 |
| 1659904712 | Amber Davis | Nurse Practitioner | 2110 S John Redditt Dr Ste D, Lufkin, TX 75904-5488 | 2020-02-18 |
| 1316592553 | Angela Moore Whitley | Nurse Practitioner | 4518 Ted Trout Dr Ste A, Lufkin, TX 75904-6642 | 2019-08-05 |
| 1801331624 | Pauline Mopur | Nurse Practitioner | 501 Crown Colony Dr, Lufkin, TX 75901-7715 | 2017-01-03 |
| 1720433865 | Irene Ifeyinwa Uke | Nurse Practitioner | East Texas Behavioral Health Network, 2001 S Medford Dr., Lufkin, TX 75901 | 2016-04-26 |
| 1700243730 | Krista L Tabler Gresham | Nurse Practitioner | 111 E Shepherd Ave, Lufkin, TX 75901-0315 | 2016-01-21 |
| 1073981460 | Christina Michelle Evett | Nurse Practitioner | 203 Christie Dr, Lufkin, TX 75904-5549 | 2015-09-02 |
| 1639545833 | Melissa Huggins | Nurse Practitioner | 415 S 1st St, Suite 130a, Lufkin, TX 75901-3869 | 2015-08-11 |
| Find all providers in LUFKIN | ||||
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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.