NICOLE MARIE CLARK (NPI# 1437765179) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1437765179 |
| Entity Type | Individual |
| Full Name | NICOLE MARIE CLARK |
| Credential | APRN |
| Practice Address |
600 Nokomis Ave S Ste 102&203 Venice FL 34285-3209 |
| Mailing Address |
21244 Wacissa Dr Venice FL 34293-2695 |
| Practice Telephone | 9414866979 |
| Mailing Telephone | 9412232455 |
| Enumeration Date | 2020-09-18 |
| Last Update Date | 2020-09-18 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
APRN11009215 | FL | Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 540 The Rialto, Venice, FL 342852900 | 9414937711 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396344826 | Nicole Clark | Home Health Aide | 1024 E 26th Ave, Columbus, OH 43211-2127 | 2020-10-26 |
| 1386106375 | Nicole Clark | Prosthetist | 100 N Burke Ave, Long Beach, MS 39560-4605 | 2019-04-01 |
| 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 |
| Street Address |
600 NOKOMIS AVE S STE 102&203 |
| City | VENICE |
| State | FL |
| Zip Code | 34285-3209 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497765895 | Joseph A Balzano | Internal Medicine | 600 Nokomis Ave S Ste 102&203, Venice, FL 34285 | 2006-08-08 |
| 1740849462 | Angela Rae Edmondson | Nurse Practitioner | 600 Nokomis Ave S Ste 102&203, Venice, FL 34285-3209 | 2019-06-06 |
| 1336674043 | Rita M Malpedo | Nurse Practitioner | 600 Nokomis Ave S Ste 102&203, Venice, FL 34285 | 2017-05-01 |
| 1184092546 | Crystal Pawula | Nurse Practitioner | 600 Nokomis Ave S Ste 102&203, Venice, FL 34285 | 2015-09-02 |
| 1497932735 | Kevin Carl O'connor | Physician Assistant | 600 Nokomis Ave S Ste 102&203, Venice, FL 34285 | 2008-01-29 |
| 1073636197 | Edmund A Bermudez | Internal Medicine | 600 Nokomis Ave S Ste 102&203, Venice, FL 34285 | 2007-04-06 |
| 1114021144 | Steven Bradshaw Shoemaker | Internal Medicine | 600 Nokomis Ave S Ste 102&203, Venice, FL 34285-3209 | 2006-09-11 |
| 1043220932 | James P Landis | Internal Medicine | 600 Nokomis Ave S Ste 102&203, Venice, FL 34285 | 2006-08-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972139871 | Safe Haven Counseling LLC | Clinic/Center | 333 S. Tamiami Trail, Suite 284, Venice, FL 34285 | 2020-03-23 |
| 1518445857 | American Eagle Venice Island LLC | Alzheimer Center (Dementia Center) | 1200 Avenida Del Circo, Venice, FL 34285 | 2018-07-30 |
| 1851886915 | Jafet Baxter | Nurse Practitioner | 333 South Tamiami Trail Suite 307, Venice, FL 34285 | 2018-06-29 |
| 1023538345 | Mary Laurie | Durable Medical Equipment & Medical Supplies | 234 Tamiami Trail S, Venice, FL 34285 | 2017-06-27 |
| 1689121584 | The Sky Family Ymca Inc. | Health Educator | 701 Center Rd, Venice, FL 34285 | 2016-09-08 |
| 1033576137 | Broy Enterprises Inc. | Durable Medical Equipment & Medical Supplies | 1205 U.S. 41 Bypass South, Venice, FL 34285 | 2016-01-20 |
| 1629444013 | George C Chamberlain | Hearing Instrument Specialist | 836 Pinebrook Rd Ste D5, Venice, FL 34285 | 2015-08-19 |
| 1801287123 | Cory O'neel | Pharmacist | 1229 Us Highway 41 Byp S, Venice, FL 34285 | 2015-02-09 |
| 1831516418 | Home Detox Inc | Counselor | 530 Us 41 Bypass So, Unit 12b, Venice, FL 34285 | 2014-03-21 |
| 1922440742 | Lynn Zittel | Occupational Therapist | 841 Venetia Bay Blvd, Venice, FL 34285 | 2013-07-22 |
| Find all providers in zip 34285 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841847720 | Joseph Matthew Adkins | Nurse Practitioner | 417 Lake of The Woods Dr, Venice, FL 34293 | 2019-08-24 |
| 1558824292 | John Huffaker | Nurse Practitioner | 333 Tamiami Trl S Ste 307, Venice, FL 34285-2428 | 2019-04-10 |
| 1609324201 | Kelly Gonzalez | Nurse Practitioner | 11814 Tempest Harbor Loop, Venice, FL 34292-3821 | 2016-09-13 |
| 1134598238 | Katie A Spada | Nurse Practitioner | 1531 Tamiami Trl S Ste 703, Venice, FL 34285-5569 | 2015-09-18 |
| 1992171755 | Rachel Martinez Franzen | Nurse Practitioner | 901 Venetia Bay Blvd Ste 110, Venice, FL 34285-8042 | 2015-08-17 |
| 1841599701 | Dawn Carole Carry | Nurse Practitioner | Venetian Hospitalist Services, 540 The Rialto, Venice, FL 34285-2900 | 2011-03-17 |
| 1821045352 | Elina S Belilovskiy | Nurse Practitioner | 425 Commercial Ct, Suite 112, Venice, FL 34292 | 2006-05-30 |
| 1376141986 | Emily Cunningham | Nurse Practitioner | 540 The Rialto, Venice, FL 34285-2900 | 2020-10-15 |
| 1205451366 | Jessica Wyckoff | Nurse Practitioner | 1415 E Venice Ave, Venice, FL 34292-3064 | 2020-06-14 |
| 1720613862 | Primecare Venice LLC | Nurse Practitioner | 1531 Tamiami Trl S Ste 703, Venice, FL 34285-5569 | 2020-03-09 |
| Find all providers in VENICE | ||||
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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.