JEANETTA CLARK (NPI# 1003298639) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1003298639 |
| Entity Type | Individual |
| Full Name | JEANETTA CLARK |
| Practice Address |
1803 N. Jackson St Centerstone of Tennessee Tullahoma TN 37388 |
| Mailing Address |
3605 Chasewood Dr Sw Apt 5 Huntsville AL 35805-5180 |
| Practice Telephone | 6154636643 |
| Mailing Telephone | 2054276509 |
| Enumeration Date | 2015-06-19 |
| Last Update Date | 2015-06-19 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YS0200X |
Counselor Specialization: School |
Behavioral Health & Social Service Providers |
| Street Address |
1803 N. JACKSON ST CENTERSTONE OF TENNESSEE |
| City | TULLAHOMA |
| State | TN |
| Zip Code | 37388 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588183628 | Angela Michelle Sowers | Dietitian, Registered | 1801 North Jackson St, Tullahoma, TN 37388 | 2017-09-09 |
| 1194242669 | Haley D Stewart | Speech-Language Pathologist | Top Rehab Services, Inc, 2110 N. Jackson Street, Tullahoma, TN 37388 | 2017-08-25 |
| 1295263150 | Kelli Elaine Spencer | Nurse Practitioner | Partners for Healing, 109 West Blackwell Street, Tullahoma, TN 37388 | 2017-05-23 |
| 1932651486 | Adam Snider | Physical Therapy Assistant | 1321 Cedar Lane, Tullahoma, TN 37388 | 2016-11-01 |
| 1891240743 | Elizabeth Riddle | Nurse Practitioner | 1805 N Jackson St Ste 11, Tullahoma, TN 37388 | 2016-08-22 |
| 1720437189 | Ronda Schrimsher | Peer Specialist | 108 E Lauderdale St, Tullahoma, TN 37388 | 2016-06-07 |
| 1285051698 | Ashley Mcmurtry | Physical Therapist | 2110 N. Jackson Street, Tullahoma, TN 37388 | 2014-03-24 |
| 1093150575 | Orthopedic Braces | Case Management | 206 Westside Dr, Tullahoma, TN 37388 | 2013-05-09 |
| 1427397199 | Kristina Danette Carter | Pharmacist | 104 North Jackson Street, Tullahoma, TN 37388 | 2013-01-31 |
| 1093094559 | Ruth Ellen Nunley | Registered Nurse | 1803 N Jackson Street, Tullahoma, TN 37388 | 2011-08-15 |
| Find all providers in zip 37388 | ||||
| Taxonomy Code | 101YS0200X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | School |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871101998 | Artriel Lynece Brown | Counselor | 4246 Appian Dr, Memphis, TN 38128-1497 | 2020-07-15 |
| 1265096473 | Lillian Kelly Mccranie | Counselor | 4421 Knight Arnold Rd, Memphis, TN 38118-2952 | 2019-04-24 |
| 1396221859 | Beatrice Settles Banks | Counselor | 3068 Covington Pike Ste 5, Memphis, TN 38128-5001 | 2018-07-17 |
| 1629565783 | Dayciaa Mccondichie | Counselor | 3393 Kirby Rd Apt 105, Memphis, TN 38115-4224 | 2018-04-15 |
| 1831609379 | Republic Schools Nashville | Counselor | 3307 Brick Church Pike, Nashville, TN 37207-2301 | 2017-10-11 |
| 1649791393 | Vachenzia Mcgraw-mckinney | Counselor | 3750 Hacks Cross Rd Ste 102-218, Memphis, TN 38125-2367 | 2017-07-03 |
| 1467996819 | Melissa Moyen | Counselor | 1340 Brown Ave Nw, Cleveland, TN 37311-1868 | 2016-12-05 |
| 1760937163 | Tara Gordon | Counselor | 2400 Union Ave, Suite 400, Memphis, TN 38112-4318 | 2016-08-16 |
| 1588014302 | Stephen Sawyer | Counselor | 705 Braidwood Dr, Nashville, TN 37214-3201 | 2016-06-14 |
| 1457719213 | Chasity Henson | Counselor | 1098 Gateview Dr, Portland, TN 37148-2166 | 2016-02-08 |
| 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.