CRYSTAL Y CLARK (NPI# 1942567763) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1942567763 |
| Entity Type | Individual |
| Full Name | CRYSTAL Y CLARK |
| Credential | FNP |
| Practice Address |
200 Raleigh Ave Beckley WV 25801-5961 |
| Mailing Address |
252 Rural Acres Dr. Beckley WV 25801 |
| Practice Telephone | 3042528541 |
| Mailing Telephone | 3042532628 |
| Enumeration Date | 2012-04-18 |
| Last Update Date | 2012-04-18 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
63168 | WV | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619581311 | Crystal Clark | Massage Therapist | 12506 Ne 4th Ave Apt 101, North Miami, FL 33161-4668 | 2020-09-01 |
| 1366068470 | Crystal Sherase Clark | Technician | 4429 Grant St Ne, Washington, DC 20019-4739 | 2020-06-24 |
| 1467014894 | Crystal Clark | Chore Provider | 153 Brambury Dr Apt D, Rochester, NY 14621-1820 | 2019-07-06 |
| 1386112050 | Crystal Lynn Clark | Internal Medicine | 12056 224th St, Cambria Heights, NY 11411-2141 | 2018-11-11 |
| 1154898179 | Crystal B Clark | Family Medicine | 112 Woodland Drive, Lancaster, SC 29720 | 2018-10-29 |
| 1801259619 | Crystal Clark | Technician, Other | 3400 State St # 750, Salem, OR 97301-5861 | 2016-03-30 |
| 1467829911 | Crystal Lynn Clark | Specialist/Technologist | 1500 Manley St, Dalton High School, Dalton, GA 30720-4088 | 2015-08-31 |
| 1386073070 | Crystal Shawn Clark | Nurse Anesthetist, Certified Registered | 240 W Sugar Loaf Rd, Tucson, AZ 85737-3756 | 2013-11-04 |
| 1417391160 | Crystal Joan Clark | Nurse Practitioner | 11930 Arbor St Ste 200, Omaha, NE 68144-2998 | 2013-04-24 |
| 1952677700 | Crystal Nache Clark | Counselor | 13902 Sage Thrasher Lane, Riverview, FL 33579 | 2012-03-27 |
| Street Address |
200 RALEIGH AVE |
| City | BECKLEY |
| State | WV |
| Zip Code | 25801-5961 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396766051 | Ely Jean Salon | Internal Medicine | 200 Raleigh Ave, Beckley, WV 25801-5989 | 2006-07-21 |
| 1699168492 | Community Health Systems Inc | Pharmacy | 200 Raleigh Ave, Beckley, WV 25801-0002 | 2015-03-18 |
| 1518190776 | Community Health Systems Inc | Pharmacy | 200 Raleigh Ave, Beckley, WV 25801-5961 | 2009-09-03 |
| 1811139165 | Community Health Systems Inc. | Clinic/Center | 200 Raleigh Ave, Beckley, WV 25801-3503 | 2009-04-01 |
| 1699819219 | E J Salon Md Inc | Internal Medicine | 200 Raleigh Ave, Beckley, WV 25801-5944 | 2007-02-16 |
| 1700920485 | R.c. Jereza M.d., Inc. | Internal Medicine | 200 Raleigh Ave, Beckley, WV 25801-5944 | 2007-02-16 |
| 1639213481 | L.c. Maramba, M.d., Inc. | Internal Medicine | 200 Raleigh Ave, Beckley, WV 25801-5944 | 2007-02-16 |
| 1538203153 | Iligino Fernandez Salon, Md, Inc | Internal Medicine | 200 Raleigh Ave, Beckley, WV 25801-5944 | 2007-02-16 |
| 1891864716 | Jennifer Marie Smith | Pharmacist | 200 Raleigh Ave, Beckley, WV 25801-0002 | 2006-11-07 |
| 1588685424 | Lamberto Cendana Maramba | Internal Medicine | 200 Raleigh Ave, Beckley, WV 25801-5944 | 2006-07-23 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144835190 | Misty Dawn Chambers | Psychologist | 154 Lagoon Way, Beckley, USA 25801 | 2020-09-15 |
| 1912511437 | Katherine Lynne Mcghee | Technician | 120 Schlager Dr., Beckley, WV 25801 | 2020-09-02 |
| 1255942421 | Tyesha Burger | Technician | 442 Industrial Dr, Beckley, WV 25801 | 2020-08-12 |
| 1053920553 | Angela Sanches | Case Manager/Care Coordinator | 134 Gooseberry Ln, Beckley, WV 25801 | 2020-07-30 |
| 1871119933 | Tiffani Michelle Dale | Counselor | 111 Coral Court, Apt 5, Beckley, WV 25801 | 2020-06-24 |
| 1679046049 | Liberty Dental Centers | Dentist | 102 Galleria Plaza, Beckley, WV 25801 | 2019-01-08 |
| 1952884942 | Susan Rae Rash | Nurse Practitioner | 250 Stanaford Rd Ste 203, Beckley, WV 25801 | 2018-09-14 |
| 1689169039 | Megan Rae Walker | Dentist | 3153 Robert C. Byrd Drive, Beckley, WV 25801 | 2018-06-28 |
| 1104318625 | Mountain State Vascular, Inc. | Surgery | 121 George Street, Beckley, WV 25801 | 2018-05-31 |
| 1356841100 | Harper Road Treatment Center LLC | Family Medicine | 1802 Harper Rd Ste 202, Beckley, WV 25801 | 2018-02-19 |
| Find all providers in zip 25801 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508418062 | Tiffanie Renee' Snyder | Nurse Practitioner | 300 Carriage Dr, Beckley, WV 25801-2812 | 2019-07-15 |
| 1467946350 | Christy Renae Smith | Nurse Practitioner | 250 Stanaford Rd Ste 209, Beckley, WV 25801-3140 | 2018-06-14 |
| 1730607870 | King's Willness and Weight Loss Centers LLC | Nurse Practitioner | 111 Morning Star Lane, Beckley, WV 25801-7118 | 2017-09-08 |
| 1366891723 | Inspire Health | Nurse Practitioner | 409 North Kanawha St., Beckley, WV 25801-3856 | 2016-06-07 |
| 1164817763 | Rural Acres Infusion, LLC | Nurse Practitioner | 117 Rural Acres Dr, Beckley, WV 25801-3579 | 2015-03-31 |
| 1790059459 | Michelle Ellis | Nurse Practitioner | 3157 Robert C. Byrd Dr., Beckley, WV 25801 | 2012-02-28 |
| 1437429362 | Peggy Jane Huffman | Nurse Practitioner | 3771 Robert C Byrd Dr, Box 1307, Beckley, WV 25801-2945 | 2012-01-10 |
| 1346510716 | John Wayne Lilly Jr. | Nurse Practitioner | 330 N. Eisenhower Dr., Beckley, WV 25801-3140 | 2012-01-03 |
| 1598992943 | Angel L Stover | Nurse Practitioner | 1810 Harper Rd, Ste A, Beckley, WV 25801-3331 | 2009-06-12 |
| 1710113022 | Cheryl Ann Winter | Nurse Practitioner | 111 Randolph St, Beckley, WV 25801-5962 | 2009-06-02 |
| Find all providers in BECKLEY | ||||
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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.