MRS. JACQUELYN IRENE CLARK (NPI# 1467503334) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1467503334 |
| Entity Type | Individual |
| Full Name | MRS. JACQUELYN IRENE CLARK |
| Credential | LPN |
| Practice Address |
48696 Benwood Rd Sardis OH 43946-9638 |
| Practice Telephone | 7404832249 |
| Mailing Telephone | 7404832249 |
| Enumeration Date | 2007-01-16 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 164W00000X | Licensed Practical Nurse | 12185 | WV | Nursing Service Providers |
| Y | 164W00000X | Licensed Practical Nurse | PN091690 | OH | Nursing Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OH | 2564130 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598390635 | Jacquelyn M Clark | Registered Nurse | 1228 Walnut St Apt 2, Cincinnati, OH 45202-7135 | 2020-03-09 |
| 1245768415 | Jacquelyn Clark | Specialist | 2000 N Beltline Blvd Apt 102e, Columbia, SC 29204-3976 | 2017-05-31 |
| 1952704744 | Jacquelyn Clark | Speech-Language Pathologist | 909 University Dr S, Huron, OH 44839-9172 | 2014-10-07 |
| 1275872327 | Jacquelyn Marie Clark | Occupational Therapist | 13400 E Shea Blvd, Scottsdale, AZ 85259-5452 | 2013-02-10 |
| 1356673263 | Jacquelyn J Clark | Counselor | 2577 Ne Courtney Dr, Bend, OR 97701-7638 | 2010-02-02 |
| Street Address |
48696 BENWOOD RD |
| City | SARDIS |
| State | OH |
| Zip Code | 43946-9638 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689086340 | Mariah Warrington | Speech-Language Pathologist | 37267 5th Ave, Sardis, OH 43946-9770 | 2014-05-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548808181 | Verda Mae Taylor | Speech-Language Pathologist | 607 Pleasant Grove Rd, Sardis, MS 38666-2639 | 2019-12-13 |
| 1619528031 | Tri-county Rural Health Services | Clinic/Center | 639a Vestal Rd, Sardis, GA 30456-2155 | 2019-09-26 |
| 1982178232 | Sharon Moore Massey | Pharmacist | 254 Walnut Rd, Sardis, MS 38666-3420 | 2019-01-18 |
| 1144793753 | Bradi Beard | Physical Therapist | 14975 Ballentine Rd, Sardis, MS 38666-5428 | 2019-01-07 |
| 1992271803 | People's Pharmacy, LLC | Pharmacy | 411 E Lee St Ste C, Sardis, MS 38666-1227 | 2018-10-17 |
| 1043703820 | First Pharmacy Services of Sardis | Pharmacy | 400 East Lee Street, Sardis, MS 38666 | 2018-06-07 |
| 1407348832 | First Pharmacy Services | Pharmacy | 400 E Lee St, Sardis, MS 38666-1236 | 2018-06-01 |
| 1770027161 | Tonya Brown | Counselor | 1801 Doyle Rd, Sardis, GA 30456-2846 | 2016-12-05 |
| 1598219511 | Love and Patience | Preferred Provider Organization | 14199 Ballentine Rd, Sardis, MS 38666-5416 | 2016-08-08 |
| 1770982001 | Wal-mart Stores East, Lp | Durable Medical Equipment & Medical Supplies | 420 E Lee St, Sardis, MS 38666-1236 | 2014-08-22 |
| Find all providers in SARDIS | ||||
| Taxonomy Code | 164W00000X |
| Grouping | Nursing Service Providers |
| Classification | Licensed Practical Nurse |
| An individual with post-high school vocational training and practical experience in the provision of nursing care at a level less than that required for certification as a Registered Nurse. Requirements for education, experience, licensure, and job responsibilities vary among the states. |
| Notes: Source: Rhea, Ott, and Shafritz, The Facts On File Dictionary of Health Care Management, New York: Facts On File Publications, 1988. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346377959 | Beverly Jean Shead | Licensed Practical Nurse | 298 Atkins St, Sardis, MS 38666-2428 | 2007-02-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346841277 | Deja Shepard | Licensed Practical Nurse | 725 Hand Ave, Cincinnati, OH 45232-1736 | 2020-11-06 |
| 1932700309 | Heather Mershon | Licensed Practical Nurse | 1535 E Hickory Grove Rd, Urbana, OH 43078-9475 | 2020-11-03 |
| 1831799774 | Kristina Maria Sorbilli | Licensed Practical Nurse | 709 N Cable Rd Ste A, Lima, OH 45805-1737 | 2020-10-29 |
| 1659971745 | Christina Johanna Ambrose | Licensed Practical Nurse | 3779 Huntmere Ave, Austintown, OH 44515-3144 | 2020-10-28 |
| 1063012227 | Stephanie Ann Mcknight | Licensed Practical Nurse | 2513 Zircon St Ne, Canton, OH 44721-1762 | 2020-10-27 |
| 1043810435 | Victoria R Berry | Licensed Practical Nurse | 3814 Charter Oak Way, Columbus, OH 43219-6150 | 2020-10-27 |
| 1578162533 | D&c Enhanced Home Healthcare Agency | Licensed Practical Nurse | 10999 Reed Hartman Hwy Ste 326, Blue Ash, OH 45242 | 2020-10-21 |
| 1457950826 | Crystal Rae Macey | Licensed Practical Nurse | 127 51st St Se, Canton, OH 44707-1013 | 2020-10-18 |
| 1205434982 | Elizabeth M Njuangang | Licensed Practical Nurse | 17603 Whitney Rd Apt 108, Strongsville, OH 44136-2447 | 2020-10-14 |
| 1023616117 | Verenda Deon Evans | Licensed Practical Nurse | 180 Brush Rd, Richmond Hts, OH 44143-1128 | 2020-10-12 |
| Find all providers with the same taxonomy | ||||
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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.