BRENT CLARK (NPI# 1952830226) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1952830226 |
| Entity Type | Individual |
| Full Name | BRENT CLARK |
| Credential | MSN, APRN, NP-C |
| Practice Address |
631 Main Street Bethel AK 99559-1908 |
| Mailing Address |
Po Box 1908 Bethel AK 99559-1908 |
| Practice Telephone | 9075433773 |
| Mailing Telephone | 9075433773 |
| Enumeration Date | 2017-06-08 |
| Last Update Date | 2019-10-11 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
122126 | AK | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508906751 | Brent Gilford Clark | Dentist | Us 23 Hayes Complex, Betsy Layne, KY 41605-0001 | 2007-02-07 |
| 1174636419 | Brent Wayne Clark | Dentist | 103 Superior Dr, Spring Lake, NC 28390-3193 | 2006-08-17 |
| 1902874456 | Brent Clark | Family Medicine | 9816 Frankstown Rd, Pittsburgh, PA 15235-1643 | 2006-03-10 |
| 1407820418 | Brent A Clark | Podiatrist | 526 N Mullan Rd, Spokane Valley, WA 99206-2408 | 2006-02-15 |
| Street Address |
631 MAIN STREET |
| City | BETHEL |
| State | AK |
| Zip Code | 99559-1908 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124078019 | Bethel Family Clinic | Clinic/Center | 631 Main Street, Bethel, AK 99559-1908 | 2006-05-11 |
| 1699207126 | Joan Ellen Daniels | Nurse Practitioner | 631 Main Street, Bethel, AK 99559 | 2017-04-03 |
| 1447560248 | Patsy Ann Cooper | Nurse Practitioner | 631 Main Street, Bethel, AK 99559-1908 | 2010-10-14 |
| 1336460245 | Dennis Raines | Counselor | 631 Main Street, Bethel, AK 99559 | 2010-06-15 |
| 1306898200 | Gloria Ann Evans | Nurse Practitioner | 631 Main Street, Bethel, AK 99559 | 2006-05-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194337519 | Michael P Nicolai | Case Manager/Care Coordinator | 829 Chief Eddie Hoffman Hey, Bethel, AK 99559 | 2020-08-18 |
| 1003438508 | Enc Physical Therapy LLC | Physical Therapist | 223 Blackberry Street, Unit A, Bethel, AK 99559 | 2020-05-07 |
| 1780229609 | Laline Knox | Massage Therapist | 107 Alex Hatley Ste 1, Bethel, AK 99559 | 2019-11-14 |
| 1659920502 | Ana Celina Sebastian | Counselor | 1380 Calista Dr, Bethel, AK 99559 | 2019-09-04 |
| 1639730484 | Jerri Linda Moran-gentle | Massage Therapist | 430 A 7th Ave, Bethel, AK 99559 | 2019-06-24 |
| 1528625381 | Jennifer Peeks | Social Worker | 631 4th Ave. & Main St., Bethel, AK 99559 | 2019-05-28 |
| 1710451190 | Mary Theresa Thibeault | Registered Nurse | Bethel Public Health Center, 1490 Eddie Hoffman Highway, Bethel, AK 99559 | 2019-01-18 |
| 1659846210 | Freda Lizann Jimmie | Counselor | 829 Eddie Hoffman Highway, Bethel, AK 99559 | 2018-10-10 |
| 1073093977 | Romeo Mullai | Counselor | 1630 Calista Drive, Bethel, AK 99559 | 2018-08-20 |
| 1235623794 | Brian Justin Moses | Day Training/Habilitation Specialist | 841 Chief Eddie Hoffman Highway, Bethel, AK 99559 | 2018-06-19 |
| Find all providers in zip 99559 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134743370 | Matthew G Horgan | Nurse Practitioner | 700 Chief Eddie Hoffman Hwy, Bethel, AK 99559-0827 | 2020-06-03 |
| 1154695641 | Kathy Brock | Nurse Practitioner | 2429 Swngs Corner Pt Isab Rd, Bethel, OH 45106-9445 | 2012-02-29 |
| 1447371174 | Laura Whitman | Nurse Practitioner | Yukon Kuskokwim Correctional Center, Pouch 400 - 1000 State Highway, Bethel, AK 99559 | 2007-04-02 |
| 1134747900 | Christopher Martin Pioli | Nurse Practitioner | 6 Stony Hill Rd, Bethel, CT 06801-1053 | 2020-07-08 |
| 1780234633 | Carly Hanson | Nurse Practitioner | 32 Railroad St, Bethel, ME 04217-3819 | 2019-09-12 |
| 1295298933 | Yasmin Santos | Nurse Practitioner | 6 Stony Hill Rd, Bethel, CT 06801-1053 | 2019-04-10 |
| 1891264727 | Laura Ann Koskenmaki | Nurse Practitioner | 528 Chief Eddie Hoffman Hwy, Bethel, AK 99559 | 2018-11-20 |
| 1053806414 | Ashley Fairbanks Glasheen | Nurse Practitioner | 528 Chief Eddie Hoffman Hwy, Bethel, AK 99559-0528 | 2018-06-28 |
| 1699207126 | Joan Ellen Daniels | Nurse Practitioner | 631 Main Street, Bethel, AK 99559 | 2017-04-03 |
| 1891226221 | Kristin Arsenault | Nurse Practitioner | 32 Railroad St, Bethel, ME 04217-1367 | 2017-03-27 |
| Find all providers in BETHEL | ||||
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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.