KECIA CLARK (NPI# 1568061950) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1568061950 |
| Entity Type | Individual |
| Full Name | KECIA CLARK |
| Credential | FNP |
| Practice Address |
3009 Englewood Dr Jennings LA 70546-3266 |
| Practice Telephone | 3373688485 |
| Mailing Telephone | 3373688485 |
| Enumeration Date | 2020-10-19 |
| Last Update Date | 2020-10-19 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
215920 | LA | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
3009 ENGLEWOOD DR |
| City | JENNINGS |
| State | LA |
| Zip Code | 70546-3266 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295374593 | Skye Ringuet | Assistant Behavior Analyst | 611 North State St., Jennings, LA 70546 | 2020-01-03 |
| 1588120612 | Southern Home Care Services, Inc | Technician | 233 N. Main St., Jennings, LA 70546 | 2019-02-13 |
| 1902399249 | Calcasieu Urgent Care LLC | Clinic/Center | 1750 Elton Rd, Jennings, LA 70546 | 2018-06-12 |
| 1407308489 | Jefferson Davis Parish Council On Aging | Non-emergency Medical Transport (VAN) | 210 South State Street, Jennings, LA 70546 | 2016-10-26 |
| 1275906372 | Elizabeth Marie Ogea | Counselor | 203 E Academy Ave, Jennings, LA 70546 | 2015-11-11 |
| 1225401706 | Taylor Farris | Counselor | 1615 Johnston Street, Suite C, Jennings, LA 70546 | 2015-11-05 |
| 1134595622 | Karen Lynn Golla | Nurse Practitioner | 422 Kade Dr Ste 1, Jennings, LA 70546 | 2015-08-19 |
| 1326301615 | Lisa Turner | Registered Nurse | 403 Baker Street, Jennings, LA 70546 | 2012-06-21 |
| 1790057149 | Cenikor Foundation | Counselor | 222 E Academy, Suite A, Jennings, LA 70546 | 2012-02-01 |
| 1821328642 | Eric P Lambousy | Physical Therapist | 1322 Elton Road, Suite I, Jennings, LA 70546 | 2009-12-29 |
| Find all providers in zip 70546 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770056301 | Angela Renee Fontenot | Nurse Practitioner | 1322 Elton Rd Ste G, Jennings, LA 70546-4100 | 2019-01-07 |
| 1134595622 | Karen Lynn Golla | Nurse Practitioner | 422 Kade Dr Ste 1, Jennings, LA 70546 | 2015-08-19 |
| 1467730531 | Matthew Paul Vincent | Nurse Practitioner | 114 N Lake Arthur Ave, Jennings, LA 70546-5738 | 2011-07-23 |
| 1750305967 | Cathy Jane Cole | Nurse Practitioner | 1907 Johnson Street, Jennings Outpatient Clinic, Jennings, LA 70546-9998 | 2006-07-27 |
| 1205448651 | Leslie B Stelly | Nurse Practitioner | 1750 Elton Rd, Jennings, LA 70546-3632 | 2020-08-18 |
| 1801442405 | Kelly Mott Whitehead | Nurse Practitioner | 1902 Johnson St, Jennings, LA 70546-3628 | 2019-08-11 |
| 1003356627 | Christian Lewis | Nurse Practitioner | 1322 Elton Rd, Suite P, Jennings, LA 70546-4100 | 2017-03-01 |
| 1477961464 | Kristen Hanks | Nurse Practitioner | 1636 Elton Rd, Suite 204, Jennings, LA 70546-3648 | 2014-07-23 |
| 1760723266 | James Christopher Andries Jr. | Nurse Practitioner | 3330 N Frontage Rd, Jennings, LA 70546-3269 | 2013-03-07 |
| 1598019978 | Jill Angelle Breaux | Nurse Practitioner | 1322 Elton Rd, Suite F, Jennings, LA 70546-4100 | 2012-11-06 |
| Find all providers in JENNINGS | ||||
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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.