MRS. KRISTINE J. CLARK (NPI# 1073795506) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1073795506 |
| Entity Type | Individual |
| Full Name | MRS. KRISTINE J. CLARK |
| Credential | O.T.C. |
| Practice Address |
Valley Orthopedic Clinic Sc 2105 E Enterprise Ave., Ste 111 Appleton WI 54913-7862 |
| Practice Telephone | 9207316611 |
| Practice Fax Number | 9207316732 |
| Mailing Telephone | 9207316611 |
| Mailing Fax Number | 9207316732 |
| Enumeration Date | 2007-11-27 |
| Last Update Date | 2007-11-27 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 246Z00000X | Specialist/Technologist, Other | Technologists, Technicians & Other Technical Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| ORTHOPAEDIC TECH-CERT | 06-0813 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093944654 | Kristine Noel Clark | Dietitian, Registered | 1471 Dewar Dr # 204, Rock Springs, WY 82901-5814 | 2009-07-03 |
| 1528230059 | Kristine Elizabeth Clark | Physical Therapist | 500 Greenbrier Drive, Charlottesville, VA 22901-1682 | 2008-03-25 |
| 1861707192 | Kristine Nicole Clark | Physician Assistant | 435 E Henrietta Rd, Box Shg, Rochester, NY 14620-4629 | 2010-08-11 |
| 1750577128 | Kristine Clark | Occupational Therapist | 130 2nd St, Neenah, WI 54956-2883 | 2007-09-19 |
| Street Address |
VALLEY ORTHOPEDIC CLINIC SC 2105 E ENTERPRISE AVE., STE 111 |
| City | APPLETON |
| State | WI |
| Zip Code | 54913-7862 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457994584 | Pamela J Andersen | Music Therapist | 245 N. Metro Drive, Appleton, WI 54913 | 2019-10-22 |
| 1396387510 | Nancy Sibley | Technician | N4423 County Road Ee, Appleton, WI 54913 | 2019-10-09 |
| 1659872240 | Meijer Stores Limited Partnership | Durable Medical Equipment & Medical Supplies | 3801 N. Richmond Street, Grand Chute, WI 54913 | 2018-02-28 |
| 1780116244 | Alison Pelger | Physician Assistant | 3916 North Intertech Court, Appleton, WI 54913 | 2017-04-03 |
| 1316311905 | Lucy Bouressa | Specialist/Technologist | 2105 E. Enterprise Ave, 113, Appleton, WI 54913 | 2015-11-19 |
| 1992189989 | Brittany Reinke | Physical Therapist | Walking and Wheeling, LLC, W4652 Glenn Street, Appleton, WI 54913 | 2015-07-20 |
| 1902280092 | Costco Wholesale Corporation | Pharmacy | 5401 W Integrity Way, Grand Chute, WI 54913 | 2015-07-17 |
| 1942646849 | Richard Anthony Mauthe | Pharmacist | 5401 W. Integrity Way, Neenah, WI 54913 | 2013-05-17 |
| 1750622163 | Tonya Janelle Wilderman | Pharmacist | 1400 N Mccarthy Rd, Apt 2, Grand Chute, WI 54913 | 2013-03-10 |
| 1295938777 | Jenna Marie Kadlec | Physical Therapist | 3916 N. Intertech Court, Appleton, WI 54913 | 2007-06-11 |
| Find all providers in zip 54913 | ||||
| Taxonomy Code | 246Z00000X |
| Grouping | Technologists, Technicians & Other Technical Service Providers |
| Classification | Specialist/Technologist, Other |
| General classification identifying individuals trained on specific equipment and technical procedures in one of a collection of miscellaneous healthcare disciplines. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073528493 | Ashley Marie Rockey | Specialist/Technologist, Other | 2105 E Enterprise Ave Ste 111, Appleton, WI 54913-7862 | 2006-07-31 |
| 1760549224 | Rodney Buchholz | Specialist/Technologist, Other | 2009 S Memorial Dr, Appleton, WI 54915-1222 | 2007-01-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780931725 | Angelina Marie Lettiere | Specialist/Technologist, Other | 3508 Stewart Ave, Wausau, WI 54401-4919 | 2012-08-09 |
| 1710244876 | Robert Pamenter | Specialist/Technologist, Other | 3424 Superior Ave, Sheboygan, WI 53081-1862 | 2012-04-13 |
| 1801081393 | Bryant Cannon | Specialist/Technologist, Other | 544 E Ogden Ave, 700-265, Milwaukee, WI 53202-2698 | 2007-09-08 |
| 1386775906 | Barbara Marie Van Lieshout | Specialist/Technologist, Other | 229 Meadow Ct, Jefferson, WI 53549-1184 | 2007-03-07 |
| 1770611741 | Steven Weber | Specialist/Technologist, Other | 305 Karen Ct, Madison, WI 53705-5026 | 2007-03-01 |
| 1962419457 | Diana Mccarthy | Specialist/Technologist, Other | 714 Oregon St, Oshkosh, WI 54902-5968 | 2006-08-01 |
| 1407337991 | Debora Armstrong | Specialist/Technologist, Other | 2001 W Broadway, Monona, WI 53713-3707 | 2018-08-23 |
| 1205372323 | Sadie Olson | Specialist/Technologist, Other | 800 Compassion Way, Dodgeville, WI 53533-1956 | 2017-01-12 |
| 1821540618 | Bryan Koudim | Specialist/Technologist, Other | 9047 W Greenfield Ave, Milwaukee, WI 53214-2808 | 2016-10-27 |
| 1710323563 | Physically Correct Physical Therapy Services, LLC | Specialist/Technologist, Other | 5889 Riverside Dr, Greendale, WI 53129-2817 | 2013-05-21 |
| 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.