BONNIE CLARK (NPI# 1508899170) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1508899170 |
Entity Type | Individual |
Full Name | BONNIE CLARK |
Credential | PA C |
Practice Address |
5400 Gibson Blvd Se Albuquerque NM 87108-4729 |
Practice Telephone | 5052627026 |
Practice Fax Number | 5057279276 |
Mailing Telephone | 5052627026 |
Mailing Fax Number | 5057279276 |
Enumeration Date | 2006-07-08 |
Last Update Date | 2008-12-18 |
Gender Code | F |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 363AM0700X |
Physician Assistant Specialization: Medical |
79-PA004 | NM | Physician Assistants & Advanced Practice Nursing Providers |
State | Issuer | Identifier | Type Code |
---|---|---|---|
NM | 59428 | 05 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1104173822 | Bonnie J Clark | Licensed Practical Nurse | 47 Caton Rd, Corning, NY 14830-3741 | 2012-08-13 |
1306134341 | Bonnie Kathleen Clark | Physical Therapist | 197 E Broadway St, Danville, IN 46122-1803 | 2011-07-12 |
1063563310 | Bonnie L Clark | Nurse Practitioner | 5 Silver Rdg, Veazie, ME 04401-7086 | 2007-01-15 |
1710074570 | Bonnie Lou Clark | Nurse Practitioner | 200 East Main Avenue, Suite 202, Bismarck, ND 58501 | 2006-10-05 |
1063989960 | Bonnie Clark | Counselor | 20370 Poe Sholes Dr, Bend, OR 97703-7938 | 2018-10-29 |
1831472133 | Bonnie Lou Clark | Nurse Practitioner | 1319 Duncan Ave, Jeffersonville, IN 47130-3759 | 2011-09-22 |
1306124540 | Bonnie Clark | Pharmacist | 3200 Vine St, Cincinnati, OH 45220-2213 | 2011-07-21 |
1770700130 | Bonnie Clark | Social Worker | 280 Princeton Avenue Ext, Corning, NY 14830-1524 | 2007-04-19 |
1376672428 | Bonnie Clark | Licensed Psychiatric Technician | 1680 Walden Ave, Cheektowaga, NY 14225-4914 | 2007-03-05 |
1154355204 | Bonnie B Clark | Nurse Practitioner | 1380 E Medical Center Dr, Suite 1500, St George, UT 84790-2123 | 2006-07-11 |
Street Address |
5400 GIBSON BLVD SE |
City | ALBUQUERQUE |
State | NM |
Zip Code | 87108-4729 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1609849975 | Jeff Scott Zabel | Internal Medicine | 5400 Gibson Blvd Se, Albuquerque, NM 87108-4729 | 2006-02-08 |
1023635299 | Khatali Telemed Services | Internal Medicine | 5400 Gibson Blvd Se, Albuquerque, NM 87108-5566 | 2020-07-02 |
1447890033 | Hypnos Anesthesia | Nurse Anesthetist, Certified Registered | 5400 Gibson Blvd Se, Albuquerque, NM 87108-4729 | 2020-01-10 |
1780155952 | Enchantment Anesthesia LLC | Nurse Anesthetist, Certified Registered | 5400 Gibson Blvd Se, Albuquerque, NM 87108-4729 | 2018-12-16 |
1275017055 | Joseph Fitz Nemeth | Nurse Practitioner | 5400 Gibson Blvd Se, Albuquerque, NM 87108-4729 | 2018-09-18 |
1134603186 | Jane Van Buskirk Huelsmann | Occupational Therapist | 5400 Gibson Blvd Se, Albuquerque, NM 87108-4729 | 2018-09-15 |
1821506882 | Michael Len Toon | Pharmacist | 5400 Gibson Blvd Se, Albuquerque, NM 87108-4729 | 2018-01-11 |
1952830648 | Marjorie S Mock | Social Worker | 5400 Gibson Blvd Se, 4th Floor, Albuquerque, NM 87108-4729 | 2017-06-07 |
1982153466 | Nadia Joseph | Counselor | 5400 Gibson Blvd Se, Albuquerque, NM 87108-4729 | 2016-09-26 |
1861940983 | Jessica Shaw | Pharmacist | 5400 Gibson Blvd Se, Albuquerque, NM 87108-4729 | 2016-09-18 |
Find all providers in the same location |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1588274393 | Aubrey Bunnenberg | Behavior Technician | 114 Pennsyvlania St. Ne Apt. 1, Albuquerque, NM 87108 | 2020-08-06 |
1336757301 | Dailey Doss | Physician Assistant | Raymond G. Murphy Va Medical Center, 1501 San Pedro Se, Albuquerque, NM 87108 | 2020-07-16 |
1457990046 | Christine Lovato | Registered Nurse | Albuquerque Treatment Services LLC, 123 Madeira Dr Se, Albuquerque, NM 87108 | 2019-12-30 |
1265074405 | Andrew Jacob Reuter | Pharmacist | 3816 Copper Ave Ne, Unit A, Albuquerque, NM 87108 | 2019-10-09 |
1518517325 | Lillian Abeyta | Technician | 1501 San Pedro Dr Se., Albuquerque, NM 87108 | 2019-09-13 |
1962970061 | Donald Borrego | Occupational Therapy Assistant | 5200 Copper Ne, #7, Albuquerque, NM 87108 | 2018-11-06 |
1154808012 | Catalina Castro | Social Worker | 209 San Pablo Se, Albuquerque, NM 87108 | 2018-07-24 |
1942721048 | Walgreen Co | Pharmacy | 933 San Mateo Blvd Ne Ste 501, Albuquerque, NM 87108 | 2017-06-29 |
1467981860 | Jennifer Martinez | Behavior Technician | 628 Espanola Se, Albuquerque, NM 87108 | 2017-06-08 |
1457892465 | J Dowd Counseling LLC | Counselor | 514 Monroe Street Se, Albuquerque, NM 87108 | 2017-03-10 |
Find all providers in zip 87108 |
Taxonomy Code | 363AM0700X |
Grouping | Physician Assistants & Advanced Practice Nursing Providers |
Classification | Physician Assistant |
Specialization | Medical |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1386284602 | Christopher Whorley | Physician Assistant | 4683 Idlewilde Ln Se, Albuquerque, NM 87108-3421 | 2020-01-15 |
1053836809 | Alysha Gallegos | Physician Assistant | 6112 Molinero Ct Sw, Albuquerque, NM 87105-6814 | 2017-08-13 |
1306225180 | Allison Rose Crossey | Physician Assistant | 201 Cedar Street Se, Suite 6600, Albuquerque, NM 87106 | 2015-05-26 |
1336543115 | Pamela O Black Md, P.a., Dba Quadra Health Institute | Physician Assistant | 3820 Commons Ave Ne # M, Albuquerque, NM 87109-5831 | 2014-10-22 |
1457686511 | Bayle R. Curtis | Physician Assistant | 1806 Morningrise Pl Se, Albuquerque, NM 87108-4520 | 2009-10-07 |
1215173919 | Amber Dawn Hansen | Physician Assistant | 1100 Cenrral Ave Se, Albuquerque, NM 87106 | 2008-12-30 |
1508028606 | Angela Genette Baumeister | Physician Assistant | 707 13th St Nw, Albuquerque, NM 87102-1841 | 2008-06-30 |
1528230117 | Laura Wylie | Physician Assistant | 1101 Medical Arts Ave Ne # 4, Building 4, Suite A, Unm Senior Health, Albuquerque, NM 87102-2706 | 2008-03-24 |
1457406951 | Deneen Tomayko | Physician Assistant | 2211 Lomas Blvd Ne Fl 4, Albuquerque, NM 87106-2745 | 2007-01-24 |
1083793665 | Karen Kay Nester | Physician Assistant | 4901 Lang Ave, Ne, Suite 100, Albuquerque, NM 87109-4597 | 2006-11-03 |
Find all providers in ALBUQUERQUE |
City | ALBUQUERQUE |
Zip Code | 87108 |
Please comment or provide details below to improve the information on BONNIE CLARK.
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.