MRS. TERRI JO CLARK (NPI# 1962954305) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1962954305 |
Entity Type | Individual |
Full Name | MRS. TERRI JO CLARK |
Credential | FNP-BC, MSN |
Practice Address |
1521 Gull Rd Kalamazoo MI 49048-1640 |
Mailing Address |
504 Adair Ct Kingsport TN 37663-2801 |
Practice Telephone | 2692267000 |
Mailing Telephone | 4234061343 |
Enumeration Date | 2016-11-02 |
Last Update Date | 2016-11-02 |
Gender Code | F |
Is Sole Proprietor | Y |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
21623 | TN | Physician Assistants & Advanced Practice Nursing Providers |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1336411107 | Terri Clark | Counselor | 21 Ne 63rd St, Oklahoma City, OK 73105-1421 | 2012-02-08 |
1942372966 | Terri Lee Clark | Registered Nurse | 1505 N Rynders St, Grand Chute, WI 54914-1614 | 2006-11-14 |
1184703159 | Terri S Clark | Technician/Technologist | 406 Highway 6 South, Oakland, IA 51560-0323 | 2006-11-02 |
1376556399 | Terri Clark | Physical Therapist | 3331 S State St, Saint Joseph, MI 49085-2458 | 2006-08-14 |
1598325896 | Terri A Clark | Physical Therapy Assistant | 1900 Oneal St, Gainesville, TX 76240-3604 | 2019-06-18 |
1770035966 | Terri Jo Clark | Nurse Practitioner | 2353 N Main St, Vidor, TX 77662-2610 | 2016-11-04 |
1750761607 | Terri L Clark | Social Worker | 10130 Perimeter Pkwy Ste 200, Charlotte, NC 28216-0197 | 2015-06-05 |
1154576130 | Terri Nikole Clark | Social Worker | 1704 Highway 69 West, Trumann, AR 72472-2029 | 2008-11-18 |
1659396919 | Terri L Clark | Nurse Anesthetist, Certified Registered | 1 Medical Park, Wheeling, WV 26003-6379 | 2006-07-13 |
1013909050 | Terri Patrice Clark | Midwife | 100 Church St S, New Haven, CT 06519-1703 | 2005-08-16 |
Street Address |
1521 GULL RD |
City | KALAMAZOO |
State | MI |
Zip Code | 49048-1640 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1225033939 | Midwestern Pathology, PC | Pathology | 1521 Gull Rd, Kalamazoo, MI 49048-1640 | 2005-06-17 |
1164038667 | Emily Thurnherr | Pharmacist | 1521 Gull Rd, Kalamazoo, MI 49048-1640 | 2020-09-20 |
1578180899 | Ceara Elaina Sibley | Dietitian, Registered | 1521 Gull Rd, Kalamazoo, MI 49048-1640 | 2020-07-02 |
1770108508 | Emily Krumbach | Pharmacist | 1521 Gull Rd, Kalamazoo, MI 49048-1640 | 2020-06-08 |
1700400686 | Emily Mccollum | Psychologist | 1521 Gull Rd, Kalamazoo, MI 49048-1640 | 2020-06-05 |
1316568850 | Adraya Gabrielle Garrett | Social Worker | 1521 Gull Rd, Kalamazoo, MI 49048-1640 | 2020-05-06 |
1114551272 | Brandy Lee Ford | Internal Medicine | 1521 Gull Rd, Kalamazoo, MI 49048-1640 | 2020-02-27 |
1689206120 | Olivia Foote | Dietitian, Registered | 1521 Gull Rd, Kalamazoo, MI 49048-1666 | 2020-02-12 |
1962035402 | Shannon Nicole Hepler | Registered Nurse | 1521 Gull Rd, Kalamazoo, MI 49048-1640 | 2020-02-12 |
1346887130 | Bethany Paige Flanagan | Dietitian, Registered | 1521 Gull Rd, Kalamazoo, MI 49048-1640 | 2019-11-29 |
Find all providers in the same location |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1790214146 | Sally Leigh Weigandt | Technician, Other | 5438 Lucerne Ave, Kalamazoo, MI 49048 | 2017-06-08 |
1437606670 | Amanda Ezekiel | Advanced Practice Midwife | 1523 Gull Rd Ste 250, Kalamazoo, MI 49048 | 2016-09-06 |
1700238987 | Brittany Bittenbender | Technician, Other | 5840 E Cork St, Kalamazoo, MI 49048 | 2016-07-12 |
1255747176 | Araena Payton | Early Intervention Provider Agency | 1313 Hotop Ave, Kalamazoo, MI 49048 | 2014-07-11 |
1508297151 | Hope Network Eastwood House | Residential Treatment Facility, Physical Disabilities | 2236 Brook Drive, Kalamazoo, MI 49048 | 2013-12-09 |
1457780314 | Hope Network Rehabilitation Servicesq | Residential Treatment Facility, Physical Disabilities | 2236 Brooke Drive, Kalamazoo, MI 49048 | 2013-11-01 |
1467889576 | Aaron Van Heest | Social Worker | 813 Chrysler St., Kalamazoo, MI 49048 | 2013-10-03 |
1760737308 | Salem A. Salem | Internal Medicine | Ascension Borgess Hospital, 1521 Gull Rd, Kalamazoo, MI 49048 | 2012-07-19 |
1356523229 | Borgess Medical Center | Psychiatry & Neurology | 1521 Gull Road, Kalamazoo, MI 49048 | 2007-12-03 |
1629290135 | Robert Claude Gano | Dentist | 5462 Gull Rd Suite 7, Kalamazoo, MI 49048 | 2007-05-03 |
Find all providers in zip 49048 |
Taxonomy Code | 363LF0000X |
Grouping | Physician Assistants & Advanced Practice Nursing Providers |
Classification | Nurse Practitioner |
Specialization | Family |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1386141018 | Jamie Kay Nevins | Nurse Practitioner | 4114 Mead St, Kalamazoo, MI 49004 | 2018-04-09 |
1477080844 | Paul Justin Rohr | Nurse Practitioner | 1717 Shaffer St Ste 232, Kalamazoo, MI 49048-1674 | 2017-05-17 |
1891146114 | Sikhanyiso Maphosa | Nurse Practitioner | 4109 Aspen Dr, Kalamazoo, MI 49006-1401 | 2016-06-28 |
1922472455 | Amy Wallace | Nurse Practitioner | 333 Portage St, Kalamazoo, MI 49007-4931 | 2015-11-20 |
1033312194 | Joan Lynn Duckworth | Nurse Practitioner | 7000 Portage Road, Kalamazoo, MI 49001 | 2007-06-07 |
1588661987 | Diana Marie Loynes | Nurse Practitioner | 8210 Keweenaw St, Kalamazoo, MI 49009-5957 | 2005-06-30 |
1063416972 | Nanette Marie Haring | Nurse Practitioner | 222 N Kalamazoo Mall, Suite 100, Kalamazoo, MI 49007-3881 | 2005-06-08 |
1710591680 | Marshe Suderman | Nurse Practitioner | 601 John St, Kalamazoo, MI 49007-5341 | 2020-09-08 |
1417561416 | Grace-fomboh Kande | Nurse Practitioner | 3601 S 9th St, Kalamazoo, MI 49009-9538 | 2020-09-07 |
1407472780 | Allison Green | Nurse Practitioner | 601 John St Ste M-273, Kalamazoo, MI 49007-5360 | 2020-06-22 |
Find all providers in KALAMAZOO |
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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.