MRS. SHANNON JACKIE CLARK (NPI# 1700940855) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1700940855 |
Entity Type | Individual |
Full Name | MRS. SHANNON JACKIE CLARK |
Practice Address |
10750 S Knoll Crest Ln Tucson AZ 85706-9052 |
Practice Telephone | 5205742911 |
Practice Fax Number | 5207500056 |
Mailing Telephone | 5205742911 |
Mailing Fax Number | 5207500056 |
Enumeration Date | 2006-12-21 |
Last Update Date | 2007-07-09 |
Gender Code | F |
Is Sole Proprietor | Y |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 171W00000X | Contractor | 11816 | AZ | Other Service Providers |
State | Issuer | Identifier | Type Code |
---|---|---|---|
AZ | 162753 | 05 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1366931552 | Shannon Clark | Registered Nurse | 8201 S 61st St, Lincoln, NE 68516-5994 | 2018-05-03 |
1457786675 | Shannon Clark | Occupational Therapy Assistant | 860 W 132nd Ave, Spc 268, Westminster, CO 80234-1499 | 2013-09-06 |
1881726271 | Shannon Denise Clark | Nurse Practitioner | 2 Easton Oval Ste 450, Columbus, OH 43219-6035 | 2007-03-12 |
1760537617 | Shannon Renee Clark | Nurse Practitioner | 3128 Santa Rita Rd, Suite C, Pleasanton, CA 94566-8300 | 2007-01-23 |
1720089311 | Shannon Lynn Clark | Chiropractor | 423 Main St, Reinbeck, IA 50669-1049 | 2005-08-03 |
1487149373 | Shannon Clark | Counselor | 90 Hospital Dr, Athens, OH 45701-2301 | 2018-06-25 |
1679021448 | Shannon Lorraine Clark | Speech-Language Pathologist | 2251 E Paris Ave Se, Grand Rapids, MI 49546-2431 | 2016-09-21 |
1508299777 | Shannon Joan Clark | Nurse Practitioner | 3604 Bush St, Raleigh, NC 27609-7511 | 2013-08-12 |
1770916033 | Shannon M Clark | Specialist/Technologist, Other | 3 Maryland Farms Ste 200, Brentwood, TN 37027-5780 | 2013-08-09 |
1700147436 | Shannon Clark | Day Training/Habilitation Specialist | 200 General St, Batesville, AR 72501-9407 | 2012-05-29 |
Street Address |
10750 S KNOLL CREST LN |
City | TUCSON |
State | AZ |
Zip Code | 85706-9052 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1326527698 | Jessica Marie Rivera | Occupational Therapy Assistant | Sunnyside Unified School District No. 12, 2238 E. Ginter Road, Tuson, AZ 85706 | 2018-08-08 |
1902249865 | Shelley Mae Lopez | Licensed Practical Nurse | 2235 E. Ginter Road, Sunnyside Unified School District No. 12, Tucson, AZ 85706 | 2013-04-10 |
1689990707 | Rhonda Rene Kendall | Registered Nurse | 2238 E. Ginter Rd, Sunnyside Unified School Districkt No 12, Tucson, AZ 85706 | 2010-04-14 |
1124262365 | David E Kohler-edwards | Military Health Care Provider | 1670 E. Perimeter Way, 162nd Medical Group/arizona Air National Guard, Tucson, AZ 85706 | 2009-04-30 |
1225205271 | Silvia Garcia | Counselor | 6420 S. Wilmot Street, Suite B301, Tucson, AZ 85706 | 2008-05-09 |
1417131426 | Brian Reasoner | Nurse Practitioner | 5369 S. Calle Santa Cruz, Suite 145 Nextcare Urgent Care, Tucson, AZ 85706 | 2007-12-27 |
1528278546 | First Script Network Services, Inc. | Durable Medical Equipment & Medical Supplies | 3535 E Valencia Rd, Tucson, AZ 85706 | 2007-05-22 |
1245447283 | Kari B Bush | Pharmacist | 3675 E Britannia, Tucson, AZ 85706 | 2007-05-17 |
1063634681 | Tara Weber | Speech-Language Pathologist | 1132 12th Street, Douglas, AZ 85706 | 2007-05-03 |
1043331028 | Sharlyn Kay Deombeleg | Technician | 5956 S Pacacho El Diablo, Tucson, AZ 85706 | 2007-04-03 |
Find all providers in zip 85706 |
Taxonomy Code | 171W00000X |
Grouping | Other Service Providers |
Classification | Contractor |
A person who contracts to supply certain materials or do certain work for a stipulated sum; esp., one whose business is contracting work in any of the building trades. For purposes of the taxonomy, a person who contracts to complete home repairs or modifications to accommodate a health condition (e.g. wheelchair ramp, kitchen counter lowering). |
Notes: Source: Websters New World Dictionary of the American Language, Second College Edition, William Collins + World Publishing Co., Inc., New York: 1974, p. 308 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1427672799 | Deborah Marie Winn | Contractor | 2960 N Swan Rd Ste 214, Tucson, AZ 85712-6020 | 2020-06-03 |
1073095840 | Rodney Johnson | Contractor | 6308 W Copper Leaf Dr, Tucson, AZ 85757-7539 | 2018-08-29 |
1861984841 | Esther Simmons | Contractor | 15918 N Forecastle Ave, Tucson, AZ 85739-9689 | 2018-06-05 |
1760992333 | Charity King | Contractor | 7502 E 33rd St, Tucson, AZ 85710-6006 | 2017-10-09 |
1598280562 | Margo Moore | Contractor | 2817 E Coconino Vis, Tucson, AZ 85713-4005 | 2017-08-10 |
1013445469 | Reina Fregoso | Contractor | 2183 E Calle Sierra Del Manantial, Tucson, AZ 85706-5090 | 2017-05-30 |
1942752530 | Guadalupe Aguirre | Contractor | 7135 S Providence Dr, Tucson, AZ 85757-6946 | 2016-10-28 |
1043769409 | Rebeca Hawkins | Contractor | 8639 N Kimball Way, Tucson, AZ 85743-5011 | 2016-09-27 |
1578019865 | Sarah Ann Roop | Contractor | 3920 E 5th St, Tucson, AZ 85711-1917 | 2016-08-28 |
1588118566 | Jonathan Oum | Contractor | 7162 E 19th St, Tucson, AZ 85710-4909 | 2016-08-08 |
Find all providers in TUCSON |
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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.