ANDREA CLARK (NPI# 1710198528) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1710198528 |
| Entity Type | Individual |
| Full Name | ANDREA CLARK |
| Credential | RENAL DIETITIAN |
| Practice Address |
720 S River Rd Ste D1100 St George UT 84790-5522 |
| Mailing Address |
85 Medical Dr # 201 Salt Lake City UT 84112-1100 |
| Practice Telephone | 4356560857 |
| Mailing Telephone | 8015818578 |
| Enumeration Date | 2007-05-24 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 133VN1005X |
Dietitian, Registered Specialization: Nutrition, Renal |
Dietary & Nutritional Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982182309 | Andrea K Clark | Occupational Therapist | 920 Goldenrod Ln, Hickman, NE 68372-9509 | 2018-07-30 |
| 1407238660 | Andrea Clark | Contractor | 2300 Seaman St, Apt. 101, Toledo, OH 43605-1952 | 2015-06-24 |
| 1114359049 | Andrea Clark | Physical Therapist | 531 Madison St, Albany, CA 94706-1116 | 2013-08-02 |
| 1003124223 | Andrea Nicole Clark | Licensed Practical Nurse | 9869 State Route 141, Kitts Hill, OH 45645-8649 | 2010-09-22 |
| 1295057362 | Andrea Serina Clark | Speech-Language Pathologist | 7497 Oak Tree Ln, Spring Hill, FL 34607-2324 | 2010-02-17 |
| 1336369602 | Andrea Walser Clark | Counselor | 157 Walser Way, Advance, NC 27006-7341 | 2007-04-27 |
| 1912034596 | Andrea Rachele Clark | Psychologist | 1818 W Lindsey St Ste C120, Norman, OK 73069-4169 | 2007-02-28 |
| 1477593580 | Andrea Clark | Counselor | 120 W 57th St, 8th Floor, New York, NY 10019-3320 | 2006-06-07 |
| 1558999672 | Andrea Clark | Registered Nurse | 1155 Dairy Ashford Rd Ste 560, Houston, TX 77079-3035 | 2020-04-01 |
| 1306359948 | Andrea Clark | Counselor | 10 Southard St, Trenton, NJ 08609-1020 | 2017-11-06 |
| Street Address |
720 S RIVER RD STE D1100 |
| City | ST GEORGE |
| State | UT |
| Zip Code | 84790-5522 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326147844 | Dixie Dialysis Center | Clinic/Center | 720 S River Rd Ste D1100, St George, UT 84790-5522 | 2006-09-21 |
| 1215197488 | Mark A Mayr | Dietitian, Registered | 720 S River Rd Ste D1100, St George, UT 84790-5522 | 2008-06-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396342713 | Katrina Poulsen | Student in an Organized Health Care Education/Training Program | 617 East Rriverside Dr, Ste 301, St. George, UT 84790 | 2020-10-08 |
| 1124643226 | Desert View Eyecare | Optometrist | 15 South River Road St. 150, St. George, UT 84790 | 2020-06-15 |
| 1366066417 | Benjamin Todd Lloyd | Dentist | 1683 E. Wolf Hole Dr, St. George, UT 84790 | 2020-06-04 |
| 1801434584 | Jennifer M Putnam | Marriage & Family Therapist | 321 North Mall Drive, Vw103, St. George, UT 84790 | 2019-12-12 |
| 1326683012 | Red Mountain Counseling and Education | Counselor | 321 No Mall Dr, Vw 103, St. George, UT 84790 | 2019-11-17 |
| 1295376002 | Karynne Kimberly Simpson | Behavior Technician | 280 N 1680 E U1, St. George, UT 84790 | 2019-10-02 |
| 1962053017 | Mikala Larsen | Nurse Practitioner | 1380 S Medical Center Dr., Saint George, UT 84790 | 2019-09-20 |
| 1326690678 | Joe Ballent | Student in an Organized Health Care Education/Training Program | 1526 S Medical Center Dr Ste 224a, St George, UT 84790 | 2019-07-16 |
| 1558923854 | David Pace | Optometrist | 749 South River Rd, St. George, UT 84790 | 2019-07-08 |
| 1639734924 | Mariah Ann Mertlich | Behavioral Analyst | 280 N 1680 E, U1, St. George, UT 84790 | 2019-05-02 |
| Find all providers in zip 84790 | ||||
| Taxonomy Code | 133VN1005X |
| Grouping | Dietary & Nutritional Service Providers |
| Classification | Dietitian, Registered |
| Specialization | Nutrition, Renal |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215197488 | Mark A Mayr | Dietitian, Registered | 720 S River Rd Ste D1100, St George, UT 84790-5522 | 2008-06-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649572884 | Sonia B Neale | Dietitian, Registered | 1672 N 1770 E, Logan, UT 84341-2178 | 2010-11-19 |
| 1083867931 | Suzanne O Ware | Dietitian, Registered | 85 Medical Dr # 201, Salt Lake City, UT 84112-1100 | 2008-10-23 |
| 1003245374 | Edith Delapp | Dietitian, Registered | 5575 S 500 E, Ogden, UT 84405-6907 | 2013-11-06 |
| 1356668438 | Barbara Sorenson Day | Dietitian, Registered | 8750 Sandy Pkwy, Sandy, UT 84070-6437 | 2010-04-28 |
| 1043532146 | Melinda Speener | Dietitian, Registered | 720 S River Rd, Suite D-1100, Saint George, UT 84790-5507 | 2010-02-17 |
| 1407095110 | Brenda Lynn Mussells | Dietitian, Registered | 85 Medical Dr # 201, Salt Lake City, UT 84112-1100 | 2009-02-19 |
| 1962680520 | Marcia Whitaker | Dietitian, Registered | 880 E 3900 S, Salt Lake City, UT 84107-2151 | 2008-02-06 |
| 1114106275 | Jill L Neilson | Dietitian, Registered | 5575 S 500 E, Ogden, UT 84405-6907 | 2007-10-25 |
Please comment or provide details below to improve the information on ANDREA 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.