KELLY PATRICIA CLARK (NPI# 1013474410) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1013474410 |
Entity Type | Individual |
Full Name | KELLY PATRICIA CLARK |
Credential | LPN |
Practice Address |
55 Pine Dr E Mason MI 48854-9229 |
Practice Telephone | 5173946484 |
Mailing Telephone | 5173946484 |
Enumeration Date | 2019-02-22 |
Last Update Date | 2019-02-22 |
Gender Code | F |
Is Sole Proprietor | Y |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 164W00000X | Licensed Practical Nurse | 4703110786 | MI | Nursing Service Providers |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1861026650 | Kelly Ann Clark | Nurse Practitioner | 4590 Childrens Pl, Saint Louis, MO 63110-1020 | 2020-03-02 |
1013497304 | Kelly Ann Clark | Case Manager/Care Coordinator | 2498 Wenona Dr, Wixom, MI 48393-2199 | 2018-08-16 |
1407336720 | Kelly Elizabeth Clark | Physical Medicine & Rehabilitation | 3800 Reservoir Rd., Bles Building, Ground Floor, Department of Pm&r, Washington, DC 20007-2113 | 2018-08-16 |
1356747448 | Kelly Clark | Dietitian, Registered | 46 Mallards Cv, Duxbury, MA 02332-3548 | 2014-11-17 |
1568883312 | Kelly Clark | Licensed Practical Nurse | 125 W Bartlette St, Apt. 110, Sumter, SC 29150-5173 | 2013-12-20 |
1306105903 | Kelly Thomas Clark | Speech-Language Pathologist | 3406 Fowler Ct, Missouri City, TX 77459-6366 | 2012-05-16 |
1619247509 | Kelly Jane Clark | Pharmacist | 328 Quail Walk Trl, Chapin, SC 29036-9791 | 2012-01-09 |
1427350461 | Kelly Darlene Clark | Chiropractor | 2425 Mahan Dr, Tallahassee, FL 32308-2301 | 2010-11-24 |
1538479324 | Kelly S Clark | Licensed Vocational Nurse | 15716 W High St # 597, Middlefield, OH 44062-9201 | 2010-10-14 |
1881715068 | Kelly Clark | Social Worker | 425 Prospect St, Northampton, MA 01060-2046 | 2007-04-03 |
Street Address |
55 PINE DR E |
City | MASON |
State | MI |
Zip Code | 48854-9229 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1669919205 | Michael Metcalf | Behavior Technician | 3470 Josephine Lane, Mason, MI 48854 | 2017-01-20 |
1891160511 | Carol Heckaman | Social Worker | 818 Charrington Ct., Mason, MI 48854 | 2015-12-07 |
1730588765 | Katherine Reeber | Social Worker | 2950 W Howell Rd, Mason, MI 48854 | 2014-08-14 |
1417383746 | Melissa F Baker | Counselor | 855 Eaton Drive, Mason, MI 48854 | 2013-09-18 |
1881940922 | Jennifer K Ogle | Social Worker | 118 W Oak St Ste 202, Mason, MI 48854 | 2012-07-26 |
1326260944 | Douglas W Gray Dds | Dentist | 230 S Temple St, Mason, MI 48854 | 2007-05-03 |
1043378185 | Timothy Joseph Zielinski | Dentist | 640 Wash, Mason, MI 48854 | 2006-12-04 |
1578635470 | Barbara Ann Begian | Physician Assistant | 790 East Columbia, Care Free Medical Inc, Mason, MI 48854 | 2006-11-15 |
1528015336 | University Rehabilitation Alliance, Inc. | Custodial Care Facility | 3181 Sandhill Rd., Mason, MI 48854 | 2006-05-27 |
1669428827 | Jeffrey Scott Deweerd | Family Medicine | 710 Temple St, Mason, MI 48854 | 2006-05-26 |
Find all providers in zip 48854 |
Taxonomy Code | 164W00000X |
Grouping | Nursing Service Providers |
Classification | Licensed Practical Nurse |
An individual with post-high school vocational training and practical experience in the provision of nursing care at a level less than that required for certification as a Registered Nurse. Requirements for education, experience, licensure, and job responsibilities vary among the states. |
Notes: Source: Rhea, Ott, and Shafritz, The Facts On File Dictionary of Health Care Management, New York: Facts On File Publications, 1988. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1881243343 | Karla Fiscal | Licensed Practical Nurse | 7644 Hedgewood Cir, Mason, OH 45040-7034 | 2019-09-08 |
1861943458 | Callie Wheeler | Licensed Practical Nurse | 4867 Bridge Ln, Apt 5, Mason, OH 45040-6947 | 2016-10-18 |
1417401829 | Donald Ray Ravenscraft | Licensed Practical Nurse | 5535 Irwin Simpson Rd, Mason, OH 45040-8107 | 2016-08-15 |
1083006662 | Melissa Martignetti | Licensed Practical Nurse | 1350 Jennings Ct, Mason, OH 45040-1116 | 2015-02-19 |
1285023903 | Lindsay Franklin | Licensed Practical Nurse | 490 Blue Spruce Ln, Mason, MI 48854-8337 | 2015-01-19 |
1710311360 | Barbara Jean Bennett | Licensed Practical Nurse | 4857 Bridge Ln, Apt 1, Mason, OH 45040-6937 | 2013-08-29 |
1003254640 | Laura Kaye Fields | Licensed Practical Nurse | 205 Westline Dr, Mason, OH 45040-1540 | 2013-06-05 |
1285070110 | Jami Michelle Spivey | Licensed Practical Nurse | 2716 Cadeira Cir, Mason, OH 45040-8001 | 2013-05-19 |
1821332909 | Amanda Feix | Licensed Practical Nurse | 4471 English Oak Ct, Mason, OH 45040-2531 | 2012-11-15 |
1942518972 | Terry Lynn Stephens | Licensed Practical Nurse | 3927 Elter Ln, Mason, OH 45040-7263 | 2010-09-24 |
Find all providers in MASON |
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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.