NATISHA IRENE CLARK


Address: 15150 Fort St, Southgate, MI 48195-1302
Phone: 7342824800

NATISHA IRENE CLARK (NPI# 1871957985) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1871957985
Entity Type Individual
Full Name NATISHA IRENE CLARK
Practice Address 15150 Fort St
Southgate
MI 48195-1302
Practice Telephone 7342824800
Practice Fax Number 7342825039
Mailing Telephone 7342824800
Mailing Fax Number 7342825039
Enumeration Date 2016-04-06
Last Update Date 2017-02-13
Gender Code F
Is Sole Proprietor Y

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
N 163W00000X Registered Nurse 4704278418 MI Nursing Service Providers
Y 363LP2300X Nurse Practitioner
Specialization: Primary Care
4704278418 MI Physician Assistants & Advanced Practice Nursing Providers

Other Provider Identifier

State Issuer Identifier Type Code
MI 1871957985 05
MI BLUE CROSS BLUE SHEILD 1871957985 01

Office Location

Street Address 15150 FORT ST
City SOUTHGATE
State MI
Zip Code 48195-1302

Providers in the same location

NPI Name Taxonomy Address Enumeration
1699777995 Mustafa A Hashem Internal Medicine 15150 Fort St, Southgate, MI 48195-1302 2005-06-01
1629693791 Diana Bischer Nurse Practitioner 15150 Fort St, Southgate, MI 48195-1302 2020-06-14
1104390350 Daniel Fenderson Nurse Practitioner 15150 Fort St, Southgate, MI 48195-1302 2019-01-21
1871958744 Saba Madhoun Physician Assistant 15150 Fort St, Southgate, MI 48195-1302 2015-12-21
1437415874 Mashkur Husain Internal Medicine 15150 Fort St, Southgate, MI 48195-1302 2012-04-10
1396976080 Ashraf Ehab Mostafa Internal Medicine 15150 Fort St, Southgate, MI 48195 2009-07-29
1225294168 Qaiser Shafiq Internal Medicine 15150 Fort St, Southgate, MI 48195 2008-07-30
1568620003 Nitin K. Gupta Internal Medicine 15150 Fort St, Southgate, MI 48195-1302 2008-05-31
1578767950 Ameen A Abdulmalik Internal Medicine 15150 Fort St, Southgate, MI 48195-1302 2007-06-12
1598968547 Abdulwahhab Alroaini Internal Medicine 15150 Fort St, Southgate, MI 48195-1302 2007-06-07
Find all providers in the same location

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1780206656 Destiny D Harris Social Worker 14799, Southgate, MI 48195 2020-05-13
1285102368 Svs Vision Inc Eyewear Supplier (Equipment, not the service) 16256 Fort St, Southgate, MI 48195 2018-11-07
1003382979 Saran Charisse Watts Case Manager/Care Coordinator 31101 Allen Rd, Building 5, Southgate, MI 48195 2018-10-18
1255824025 Kiesta Janell Lindsey Social Worker 13101 Allen Rd Bldg 4-f, Southgate, MI 48195 2018-06-07
1417473224 Suzette Michele Watson Nurse Practitioner 14319 Dix-toledo, Southgate, MI 48195 2017-08-15
1275069486 Liza Du Plessis Student in an Organized Health Care Education/Training Program 13111 Allen Road, Southgate, MI 48195 2017-05-08
1497290456 Beaumont Health Clinic/Center 15777 Northline, Southgate, MI 48195 2016-12-30
1184172876 Felicia Wilson Licensed Practical Nurse 15771 Wildemere, Southgate, MI 48195 2016-09-12
1225487978 Stacey Petrick-strickland Technician, Other 12189 Agnes, Southgate, MI 48195 2016-06-03
1205298486 Ashley Francis Hearing Instrument Specialist 18800 Eureka Rd., Southgate, MICHIGAN 48195 2016-03-25
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Taxonomy Information

Taxonomy Code 363LP2300X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Nurse Practitioner
Specialization Primary Care

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1912490129 Lekisha R Weathersby Nurse Practitioner 13667 Eureka Rd, Southgate, MI 48195-1332 2018-06-12
1649770652 Valeria Concetta Smith Nurse Practitioner 15750 Northline Rd, Southgate, MI 48195-2378 2018-02-16

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1447859731 Cindy Clare Craig Nurse Practitioner 4142 Cranberry Ln, Williamsburg, MI 49690-8641 2020-10-19
1487269536 Christiane Ines Atowo Nurse Practitioner 25420 5 Mile Rd, Redford, MI 48239-3837 2020-09-14
1760095137 Gina Louise Bennett Nurse Practitioner 4871 Harwood Rd, Ionia, MI 48846-9422 2020-08-26
1356953756 John Westley Mailey Jr. Nurse Practitioner 27645 Albert St, Novi, MI 48374-1012 2020-08-18
1356951305 Michelle Lynn Andriacchi Nurse Practitioner 45690 Kenmore St, Shelby Township, MI 48317-4656 2020-08-05
1124646476 Chand Sheoran Nurse Practitioner 3040 Albany Ct, Troy, MI 48083-2595 2020-07-13
1104449214 Lynn Marie Alexanders-klima Nurse Practitioner 6697 Summerdale Ct E, Ypsilanti, MI 48197-6140 2020-05-22
1326660580 Kristin A Furwa Nurse Practitioner 600 Health Park Blvd Ste H, Grand Blanc, MI 48439-2558 2020-05-11
1700412582 Ashley Ruth Zimmerman Nurse Practitioner 6223 Brant Ln, Ypsilanti, MI 48197-8742 2020-03-12
1992339139 Afusat Ahmed Nurse Practitioner 5231 Madison Ave Apt A5, Okemos, MI 48864-1172 2020-02-26
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Competitor

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City SOUTHGATE
Zip Code 48195

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Dataset Information

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.

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