CRYSTAL JOAN CLARK (NPI# 1417391160) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417391160 |
| Entity Type | Individual |
| Full Name | CRYSTAL JOAN CLARK |
| Credential | APRN |
| Practice Address |
11930 Arbor St Ste 200 Omaha NE 68144-2998 |
| Practice Telephone | 4026971601 |
| Mailing Telephone | 4026971601 |
| Enumeration Date | 2013-04-24 |
| Last Update Date | 2013-04-24 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LA2100X |
Nurse Practitioner Specialization: Acute Care |
111457 | NE | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363LA2200X |
Nurse Practitioner Specialization: Adult Health |
111457 | NE | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619581311 | Crystal Clark | Massage Therapist | 12506 Ne 4th Ave Apt 101, North Miami, FL 33161-4668 | 2020-09-01 |
| 1366068470 | Crystal Sherase Clark | Technician | 4429 Grant St Ne, Washington, DC 20019-4739 | 2020-06-24 |
| 1467014894 | Crystal Clark | Chore Provider | 153 Brambury Dr Apt D, Rochester, NY 14621-1820 | 2019-07-06 |
| 1386112050 | Crystal Lynn Clark | Internal Medicine | 12056 224th St, Cambria Heights, NY 11411-2141 | 2018-11-11 |
| 1154898179 | Crystal B Clark | Family Medicine | 112 Woodland Drive, Lancaster, SC 29720 | 2018-10-29 |
| 1801259619 | Crystal Clark | Technician, Other | 3400 State St # 750, Salem, OR 97301-5861 | 2016-03-30 |
| 1467829911 | Crystal Lynn Clark | Specialist/Technologist | 1500 Manley St, Dalton High School, Dalton, GA 30720-4088 | 2015-08-31 |
| 1386073070 | Crystal Shawn Clark | Nurse Anesthetist, Certified Registered | 240 W Sugar Loaf Rd, Tucson, AZ 85737-3756 | 2013-11-04 |
| 1952677700 | Crystal Nache Clark | Counselor | 13902 Sage Thrasher Lane, Riverview, FL 33579 | 2012-03-27 |
| 1639443658 | Crystal A Clark | Chore Provider | 331 Jamestown Ct, Columbus, OH 43228-4030 | 2012-03-08 |
| Street Address |
11930 ARBOR ST STE 200 |
| City | OMAHA |
| State | NE |
| Zip Code | 68144-2998 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720627292 | Jessica Wissink | Physical Therapist | 2275 South 132nd St, Omaha, NE 68144 | 2020-01-02 |
| 1881165397 | Elle Klink | Chiropractor | 2527 S 140th Street, Omaha, NE 68144 | 2018-12-10 |
| 1336649987 | Colton A Palmer | Nurse Practitioner | 11725 Arbor St Ste 230, Omaha, NE 68144 | 2018-02-20 |
| 1780121335 | Deborah Palmer | Massage Therapist | 2429 South 120th, Omaha, NE 68144 | 2017-01-20 |
| 1750833851 | Amanda Mcgary Tatro | Counselor | 11929 Elm St Suite 12a, Omaha, NE 68144 | 2016-10-25 |
| 1770946105 | Kindis Ward | Counselor | 13435 A. Street, Omaha, NE 68144 | 2016-04-02 |
| 1649679937 | Brian Douglas Smith | Physical Therapist | 13934 Gold Circle, Omaha, NE 68144 | 2014-08-22 |
| 1346587334 | Elite Professionals Home Care LLC | Home Health | 13306 A Street, Omaha, NE 68144 | 2013-01-10 |
| 1821345471 | Angelia D Henderson | Skilled Nursing Facility | 2525 S. 135th Ave, Omaha, NE 68144 | 2012-08-13 |
| 1073872123 | Midwest Physical Therapy Services, PC | Physical Therapist | 11640 Arbor Street #200, Omaha, NE 68144 | 2012-05-10 |
| Find all providers in zip 68144 | ||||
| Taxonomy Code | 363LA2100X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Acute Care |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164022828 | Caitlin Korbelik | Nurse Practitioner | 982315 Nebraska Medical Ctr, Omaha, NE 68198-2315 | 2020-10-30 |
| 1346854759 | Amanda Elsome | Nurse Practitioner | 5816 Valley Cir, Omaha, NE 68106-3767 | 2020-09-02 |
| 1740622372 | Ashley M Ortiz | Nurse Practitioner | 4350 Dewey Avenue, Omaha, NE 68105 | 2013-07-24 |
| 1942554811 | Michele Christina Balas | Nurse Practitioner | 985330 Nebraska Medical Center, Omaha, NE 68198-5330 | 2012-10-31 |
| 1508175894 | Tara D Morton | Nurse Practitioner | 4350 Dewey Ave, Omaha, NE 68105-1017 | 2010-10-04 |
| 1295332674 | Megan Elizabeth Ruffcorn | Nurse Practitioner | 8200 Dodge St, Omaha, NE 68114-4113 | 2020-10-08 |
| 1275158909 | Rebecca M Toomsen | Nurse Practitioner | 7500 Mercy Rd, Omaha, NE 68124-2319 | 2020-06-09 |
| 1770106783 | Jennifer E Cook | Nurse Practitioner | 7500 Mercy Rd, Omaha, NE 68124-2319 | 2020-05-26 |
| 1710530589 | Lindsey C Leyden | Nurse Practitioner | 8200 Dodge St, Omaha, NE 68114-4113 | 2019-07-22 |
| 1225681414 | Kaitlin Maasdam | Nurse Practitioner | 7500 Mercy Rd, Omaha, NE 68124-2319 | 2019-07-17 |
| Find all providers in OMAHA | ||||
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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.