LATOSSIA BRUNELL CLARK (NPI# 1932689551) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1932689551 |
| Entity Type | Individual |
| Full Name | LATOSSIA BRUNELL CLARK |
| Practice Address |
1058 George Bridges Rd Crawford MS 39743-9425 |
| Practice Telephone | 6623521375 |
| Mailing Telephone | 6623521375 |
| Enumeration Date | 2018-08-14 |
| Last Update Date | 2018-08-14 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 133V00000X | Dietitian, Registered | 1067835 | MS | Dietary & Nutritional Service Providers |
| Street Address |
1058 GEORGE BRIDGES RD |
| City | CRAWFORD |
| State | MS |
| Zip Code | 39743-9425 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639645989 | Tameka Davis | Non-emergency Medical Transport (VAN) | 79 Short St, Crawford, MS 39743 | 2018-10-15 |
| 1265903074 | D&t Transportation of Crawford LLC | Non-emergency Medical Transport (VAN) | 79 Short St, Crawford, MS 39743 | 2018-12-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386243335 | Jessica Rowan | Technician | 1354 Straight Fork Rd, Crawford, WV 26343-8500 | 2020-10-21 |
| 1952913568 | Jessica Dawn Bennington | Technician | 42 Heater Dr, Crawford, WV 26343-4302 | 2020-08-17 |
| 1073124962 | Lindsey Pate | Counselor | 325 Buck Run Rd, Crawford, TX 76638-3448 | 2020-08-13 |
| 1245852185 | Service Drugs, Inc. | Pharmacy | 202 Main St., Crawford, NE 69339-1026 | 2020-05-14 |
| 1386275469 | Gateways To Transformation LLC | Community/Behavioral Health | 4979 4200 Rd, Crawford, CO 81415-9178 | 2020-01-28 |
| 1497398507 | Laniece Maria Appling | Driver | 245 S Woodlawn Dr, Crawford, GA 30630-2622 | 2019-10-21 |
| 1639645989 | Tameka Davis | Non-emergency Medical Transport (VAN) | 79 Short St, Crawford, MS 39743 | 2018-10-15 |
| 1679053078 | Sherman Douglas Crow | Physical Therapy Assistant | 4677 Baylor Camp Rd, Crawford, TX 76638-3199 | 2018-08-16 |
| 1790176907 | Optimum Healthcare Solutions | Durable Medical Equipment & Medical Supplies | 245 N. Street, Crawford, GA 30648 | 2015-02-10 |
| 1952799660 | Abigail Bennett | Specialist/Technologist | 200 Pirate Dr, Crawford, TX 76638-3159 | 2015-01-03 |
| Find all providers in CRAWFORD | ||||
| Taxonomy Code | 133V00000X |
| Grouping | Dietary & Nutritional Service Providers |
| Classification | Dietitian, Registered |
| A registered dietician (RD) is a food and nutrition expert who has successfully completed a minimum of a bachelor’s degree at a US regionally accredited university or college and course work approved by The American Dietetic Association (ADA); an ADA-accredited or approved, supervised practice program, typically 6 to 12 months in length; a national examination administered by the Commission on Dietetic Registration; and continuing professional educational requirements to maintain registration. |
| Notes: Source: The American Dietetic Association. Becoming a Registered Dietitian – a food and nutrition expert. Chicago, IL: The American Dietetic Association, July 1997. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104427780 | Ronald Dwayne Woods | Dietitian, Registered | 1 Ashton Gardens Dr, Jackson, MS 39211-4275 | 2020-11-02 |
| 1720690845 | Timmi Unger Bishop | Dietitian, Registered | 188 Bream Rd, Mantachie, MS 38855-8571 | 2020-08-19 |
| 1033734348 | Jaclyn Wehrle | Dietitian, Registered | 122 Virginia Dr, Hattiesburg, MS 39401-5832 | 2020-06-11 |
| 1447875893 | Jaden Nichole Tabat | Dietitian, Registered | 400 Shadow Creek Dr Unit 400, Oxford, MS 38655-6227 | 2020-06-11 |
| 1467080580 | Kimberly Marie Chapman | Dietitian, Registered | 312 Pine Ridge Pt, Petal, MS 39465-4241 | 2020-04-01 |
| 1437783420 | Sara E Foster | Dietitian, Registered | 36 Craft Rd, Petal, MS 39465-9335 | 2020-02-27 |
| 1922639046 | Anna Brashier | Dietitian, Registered | 410 White Oak St, Waynesboro, MS 39367-2546 | 2020-01-28 |
| 1821628967 | Joanne Alison Levanway | Dietitian, Registered | 13701 Hidden Oaks Dr, Gulfport, MS 39503-7025 | 2020-01-16 |
| 1629615489 | Lynne Victoria Longman | Dietitian, Registered | 2424 Weeping Willow Cir, Hattiesburg, MS 39402-6090 | 2019-11-28 |
| 1083250187 | Heather Ruthann Jenkins | Dietitian, Registered | 2646 Cherry Tree Dr, Southaven, MS 38672-8016 | 2019-11-23 |
| Find all providers with the same taxonomy | ||||
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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.