MR. EVAN JACOB CLARK (NPI# 1154819951) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1154819951 |
| Entity Type | Individual |
| Full Name | MR. EVAN JACOB CLARK |
| Practice Address |
9200 W Wisconsin Ave # 1p Milwaukee WI 53226-3522 |
| Practice Telephone | 4148056450 |
| Mailing Telephone | 4148056450 |
| Enumeration Date | 2018-04-26 |
| Last Update Date | 2018-04-26 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083071443 | Evan Leigh Clark | Nurse Practitioner | 546 Lone Oak Rd, Paducah, KY 42003-4526 | 2016-01-15 |
| Street Address |
9200 W WISCONSIN AVE # 1P |
| City | MILWAUKEE |
| State | WI |
| Zip Code | 53226-3522 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780115634 | Sean Anthony Mackman | Emergency Medicine | 9200 W Wisconsin Ave # 1p, Milwaukee, WI 53226-3522 | 2017-03-22 |
| 1346739042 | David Thomas Koenig | Emergency Medicine | 9200 W Wisconsin Ave # 1p, Milwaukee, WI 53226-3522 | 2018-05-08 |
| 1326543646 | Ally E Esch | Student in an Organized Health Care Education/Training Program | 9200 W Wisconsin Ave # 1p, Milwaukee, WI 53226-3522 | 2018-03-28 |
| 1922531235 | Justine Wergin | Emergency Medicine | 9200 W Wisconsin Ave # 1p, Milwaukee, WI 53226-3522 | 2017-04-04 |
| 1205368735 | Joseph Lawton | Student in an Organized Health Care Education/Training Program | 9200 W Wisconsin Ave # 1p, Milwaukee, WI 53226-3522 | 2017-04-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912511155 | Alexander Harlan | Pharmacist | 900 N 92nd St, Milwaukee, WI 53226 | 2020-09-04 |
| 1558985762 | Armghan Haider Ans | Student in an Organized Health Care Education/Training Program | 9200 W. Wisconsin Ave. Froedtert Hospital & Medical Col, Milwaukee, WI 53226 | 2020-06-03 |
| 1669001103 | Kimberly Tyler | Student in an Organized Health Care Education/Training Program | 8701 W Watertown Plank Road, Medical College of Wisconsin Dept of Internal Medicine, Wauwatosa, WI 53226 | 2020-04-06 |
| 1972131993 | Francesca Meloy Devine | Student in an Organized Health Care Education/Training Program | Medical Education Office: Children's Corporate Center, 999 N. 92nd St., Suite 730, Milwaukee, WI 53226 | 2020-03-27 |
| 1285275248 | Sharitta Alford | Technician | 12250 West North Avenue, Apartment 142b, Wauwatosa, WI 53226 | 2019-10-01 |
| 1619528023 | Linda Marie Sabatinelli | Technician | 12107 W. Woodland Ave, Wauwatosa, WI 53226 | 2019-09-26 |
| 1598310195 | Matthew Laviolette | Surgery | Medical College of Wisconsin, 8701 Watertown Plank Rd., Surgical Oncology, Milwaukee, WI 53226 | 2019-08-09 |
| 1962056432 | Lyndsey Marie Bratberg | Physician Assistant | F&mcw Clinical Cancer Center 9200 W. Wisconsin Ave., Milwaukee, WI 53226 | 2019-08-01 |
| 1659832855 | Benjamin David Seadler | Surgery | Mcw, Department of Surgery, 8701 Watertown Plank Road, Milwaukee, WI 53226 | 2019-03-29 |
| 1861953267 | Michael Dryden | Student in an Organized Health Care Education/Training Program | 8701 Watertown Plank Rd., Milwaukee, WI 53226 | 2019-03-27 |
| Find all providers in zip 53226 | ||||
| Taxonomy Code | 390200000X |
| Grouping | Student, Health Care |
| Classification | Student in an Organized Health Care Education/Training Program |
| An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |
| Notes: [1/1/2005: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588275226 | Benjamin N Wasserman | Student in an Organized Health Care Education/Training Program | 3487 N Lake Dr, Milwaukee, WI 53211-2919 | 2020-08-16 |
| 1831707991 | Teresa Marie Ilardi | Student in an Organized Health Care Education/Training Program | 500 W Bradley Rd Apt 127a, Milwaukee, WI 53217-2618 | 2020-07-15 |
| 1053938167 | Joe Dalton | Student in an Organized Health Care Education/Training Program | 1431 N 53rd St, Milwaukee, WI 53208-2227 | 2020-07-06 |
| 1326663790 | Amber Frances Wegner | Student in an Organized Health Care Education/Training Program | 3050 S 62nd St, Milwaukee, WI 53219-3039 | 2020-06-11 |
| 1558985762 | Armghan Haider Ans | Student in an Organized Health Care Education/Training Program | 9200 W. Wisconsin Ave. Froedtert Hospital & Medical Col, Milwaukee, WI 53226 | 2020-06-03 |
| 1194349688 | Nikole Anne Bruno | Student in an Organized Health Care Education/Training Program | 2160 S Kinnickinnic Ave Apt 327, Milwaukee, WI 53207-1345 | 2020-06-01 |
| 1598389124 | Amanda Philbin | Student in an Organized Health Care Education/Training Program | 6834 W Cold Spring Rd, Milwaukee, WI 53220-2909 | 2020-05-29 |
| 1992328603 | Amanda Kathryn Browning | Student in an Organized Health Care Education/Training Program | 1123 E Van Beck Ave, Milwaukee, WI 53207-4525 | 2020-05-28 |
| 1548899875 | Brittany Schall | Student in an Organized Health Care Education/Training Program | 945 N 12th St # 3105, Milwaukee, WI 53233-1305 | 2020-04-07 |
| 1841829918 | Joshua Michael Brooks | Student in an Organized Health Care Education/Training Program | Aurora St. Lukes Medical Center 2901 W Oklahoma Ave, Milwaukee, WI 53215 | 2020-04-02 |
| Find all providers in MILWAUKEE | ||||
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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.