NICHOLE N CLARK


Address: 3200 E Racine St, Janesville, WI 53546-2343
Phone: 6083718000

NICHOLE N CLARK (NPI# 1093377905) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1093377905
Entity Type Individual
Full Name NICHOLE N CLARK
Credential APNP
Practice Address 3200 E Racine St
Janesville
WI 53546-2343
Mailing Address 1808 W Beltline Hwy
Madison
WI 53713-2334
Practice Telephone 6083718000
Practice Fax Number 6083718939
Mailing Telephone 6082501497
Mailing Fax Number 6082501384
Enumeration Date 2019-07-01
Last Update Date 2020-11-05
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 363L00000X Nurse Practitioner 10067 WI Physician Assistants & Advanced Practice Nursing Providers
N 363LF0000X Nurse Practitioner
Specialization: Family
209019549 IL Physician Assistants & Advanced Practice Nursing Providers

Other Provider Identifier

State Issuer Identifier Type Code
WI 1093377905 05

Other Providers NICHOLE CLARK

NPI Name Taxonomy Address Enumeration
1548464936 Nichole Deann Clark Nurse Practitioner 145 Shakerag Road, Clinton, AR 72031-6657 2007-06-12
1962923995 Nichole Clark Behavioral Analyst 13300 Hickman Rd Ste 110, Clive, IA 50325-8616 2017-06-29

Office Location

Street Address 3200 E RACINE ST
City JANESVILLE
State WI
Zip Code 53546-2343

Providers in the same location

NPI Name Taxonomy Address Enumeration
1124026208 Mark C. Torres Obstetrics & Gynecology 3200 E Racine St, Janesville, WI 53546-2343 2005-07-12
1033719703 Macy G Bolt Physical Therapist 3200 E Racine St, Janesville, WI 53546-2343 2020-10-30
1407489016 Joy P. Thompson Nurse Practitioner 3200 E Racine St, Janesville, WI 53546-2343 2020-02-21
1851938419 Hatsuho Wilkinson Dietitian, Registered 3200 E Racine St, Janesville, WI 53546-2343 2019-12-03
1013563394 Karrie R Lynch Nurse Practitioner 3200 E Racine St, Janesville, WI 53546-2343 2019-08-13
1679128771 Ellen Jean Ettlie Nurse Practitioner 3200 E Racine St, Janesville, WI 53546-2343 2019-08-06
1881249126 Elizabeth F Ramer Nurse Practitioner 3200 E Racine St, Janesville, WI 53546-2343 2019-08-05
1386202448 Nicole M. Wentzien Physical Therapist 3200 E Racine St, Janesville, WI 53546-2343 2019-06-04
1407322084 Mark William Dantuma Nurse Practitioner 3200 E Racine St, Janesville, WI 53546-2343 2018-10-22
1083199418 Rebecca L Wergin Nurse Practitioner 3200 E Racine St, Janesville, WI 53546-2343 2018-10-02
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1366911489 Latoya Christina Anderson Counselor 1818 Pershing Pl, Janesville, WI 53546 2018-11-19
1922599216 Megan Arney Speech-Language Pathologist 9680, 4445 Woodgate Dr., Janesville, WI 53546 2018-05-23
1770089955 Abby Marie Harnack Registered Nurse 3901 Teal Ln, Janesville, WI 53546 2018-04-05
1962773648 Clark Carroll Nurse Practitioner 1820 Center Ave, Janesville, WI 53546 2012-01-26
1689983793 Fve Mw LLC Assisted Living Facility 3801 North Wright Road, Janesville, WI 53546 2010-10-07
1831354794 County of Rock County Clerk Community/Behavioral Health 3506 Hwy 51, Janesville, WI 53546 2008-07-21
1528225422 Walgreen Co Pharmacy 2519 Kettering St, Janesville, WI 53546 2008-05-19
1447420351 Michele Renee Bohland Physical Therapy Assistant 2540 Humes Rd, Janesville, WI 53546 2008-03-06
1093992158 Emma Gene Harrell Counselor 203 W Sunny Lane, Janesville, WI 53546 2008-01-30
1457473696 Robert Louis Fleming Dentist 910 Conde St, Janesville, WI 53546 2007-04-06
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Taxonomy Information

Taxonomy Code 363L00000X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Nurse Practitioner

Taxonomy Definition

(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.
Notes: Source: (1) American Nurses’ Association, American Nurses Credentialing Center, 1996 Certification Catalogue. (2) ) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 549.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1407489016 Joy P. Thompson Nurse Practitioner 3200 E Racine St, Janesville, WI 53546-2343 2020-02-21
1013563394 Karrie R Lynch Nurse Practitioner 3200 E Racine St, Janesville, WI 53546-2343 2019-08-13
1679128771 Ellen Jean Ettlie Nurse Practitioner 3200 E Racine St, Janesville, WI 53546-2343 2019-08-06
1881249126 Elizabeth F Ramer Nurse Practitioner 3200 E Racine St, Janesville, WI 53546-2343 2019-08-05
1407322084 Mark William Dantuma Nurse Practitioner 3200 E Racine St, Janesville, WI 53546-2343 2018-10-22
1083199418 Rebecca L Wergin Nurse Practitioner 3200 E Racine St, Janesville, WI 53546-2343 2018-10-02
1437662574 Dayna C Osborne Nurse Practitioner 1000 Mineral Point Ave, Janesville, WI 53548-2940 2017-11-12
1235656976 Amanda L Kilcoyne Nurse Practitioner 3200 E Racine St, Janesville, WI 53546-2343 2017-08-24
1972025021 Heidi M. Rye Nurse Practitioner 3200 E Racine St, Janesville, WI 53546-2343 2017-07-11
1932648771 Courtney E Castelein Nurse Practitioner 1000 Mineral Point Ave, Janesville, WI 53548-2940 2017-02-13
Find all providers in JANESVILLE

Competitor

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City JANESVILLE
Zip Code 53546

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Dataset Information

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.

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