MRS. KOLU S. BAYSAH CLARK (NPI# 1336535624) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1336535624 |
Entity Type | Individual |
Full Name | MRS. KOLU S. BAYSAH CLARK |
Practice Address |
1 Harvard Rd Shirley MA 01464-2434 |
Mailing Address |
149 Pomona Ave Providence RI 02908-5123 |
Practice Telephone | 9784254341 |
Mailing Telephone | 4015855864 |
Enumeration Date | 2015-04-13 |
Last Update Date | 2015-04-13 |
Gender Code | F |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 363LP2300X |
Nurse Practitioner Specialization: Primary Care |
APRN00086 | RI | Physician Assistants & Advanced Practice Nursing Providers |
Y | 363LP2300X |
Nurse Practitioner Specialization: Primary Care |
RN2269378 | MA | Physician Assistants & Advanced Practice Nursing Providers |
Street Address |
1 HARVARD RD |
City | SHIRLEY |
State | MA |
Zip Code | 01464-2434 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1245279330 | Jeri A Walker | Psychiatry & Neurology | 1 Harvard Rd, Mci Shirley, Shirley, MA 01464 | 2006-06-05 |
1043775562 | Desire Huckfeldt Kangsen | Nurse Practitioner | 1 Harvard Rd, Shirley, MA 01464-2434 | 2019-02-08 |
1972087559 | Karen Angela Sotiropoulos | Social Worker | 1 Harvard Rd, Shirley, MA 01464-2434 | 2018-09-20 |
1811470842 | Jessalyn Vieweg | Social Worker | 1 Harvard Rd, Shirley, MA 01464-2434 | 2018-09-14 |
1932616299 | Marco Felipe Antunes Ribeiro | Nurse Practitioner | 1 Harvard Rd, Shirley, MA 01464-2434 | 2018-01-08 |
1548713308 | Felicitas Fandreyer | Clinical Nurse Specialist | 1 Harvard Rd, Shirley, MA 01464-2434 | 2016-07-28 |
1073984217 | Eugenia Trammell-goldsby | Registered Nurse | 1 Harvard Rd, Shirley, MA 01464-2434 | 2015-10-14 |
1588004527 | Joan Bei Kima-tabong | Nurse Practitioner | 1 Harvard Rd, Shirley, MA 01464-2434 | 2013-07-03 |
1205118668 | Bartholomew Nelson | Nurse Practitioner | 1 Harvard Rd, Shirley, MA 01464-2434 | 2011-09-12 |
1912114885 | John M Beland | Counselor | 1 Harvard Rd, Shirley, MA 01464-2434 | 2007-05-17 |
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NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1477107910 | Deanna Louise Benjamin | Nurse Practitioner | Harvard Rd, Shirley, MA 01464 | 2019-08-01 |
1588148779 | Heidi Rose Wilson | Licensed Practical Nurse | 100 Harvard Rd, Shirley, MA 01464 | 2018-09-24 |
1205351772 | Isaac Muffoletto | Acupuncturist | 2 Shaker Rd Ste B007, Shirley, MA 01464 | 2017-08-07 |
1396116307 | Nadine Mae Amato | Nurse Practitioner | Harvard Road, Shirley, MA 01464 | 2015-10-16 |
1073904140 | Mhm Health Professionals, Inc | Nurse Practitioner | Havard Road, Shirley, MA 01464 | 2015-02-11 |
1972909513 | William Thuo | Nurse Practitioner | 1 Havard Rd, Shirley, MA 01464 | 2014-11-10 |
1982202073 | Stella Macharia | Family Medicine | 100 Harvard Rd, Shirley, MA 01464 | 2020-10-12 |
1477943637 | Tamara Elizabeth Perini | Social Worker | 20 Fredonian Street, Shirley, MA 01464-1144 | 2015-01-27 |
1134441157 | Rose-ann Buchman | Physical Therapist | 14 Mount Henry Rd, Shirley, MA 01464-2011 | 2010-02-17 |
1750775771 | Henrick Hamberg | Health Educator | 14 Mount Henry Rd, Shirley, MA 01464-2011 | 2015-03-27 |
Find all providers in zip 01464 |
Taxonomy Code | 363LP2300X |
Grouping | Physician Assistants & Advanced Practice Nursing Providers |
Classification | Nurse Practitioner |
Specialization | Primary Care |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1760082366 | Donna Josephine Remmes | Nurse Practitioner | 313 Franklin St, Wrentham, MA 02093-2405 | 2020-11-01 |
1912513714 | James Vincent Fournier | Nurse Practitioner | 50 Memorial Dr Ste 205, Leominster, MA 01453-2238 | 2020-09-17 |
1386259109 | Maureen Villars | Nurse Practitioner | 32 Orchard Hill Dr, Rutland, MA 01543-1778 | 2020-09-09 |
1639783780 | Patricia Varela | Nurse Practitioner | 48 Percival St, Dorchester, MA 02122-1992 | 2020-09-05 |
1578172243 | Felicia Mendonca | Nurse Practitioner | 21 Lands End Way, Swansea, MA 02777-2909 | 2020-07-28 |
1831716901 | Joan Tiano | Nurse Practitioner | 595 Pawtucket Blvd Ste 3, Lowell, MA 01854-2042 | 2020-07-06 |
1720609829 | Angelique Group | Nurse Practitioner | 4 Upland Woods Cir Unit 402, Norwood, MA 02062-3261 | 2020-04-29 |
1093341331 | Frew Fikru | Nurse Practitioner | 529 Washington Ave Apt 2, Revere, MA 02151-1962 | 2020-03-18 |
1376189084 | Dorcas Korir | Nurse Practitioner | 248 Pleasant St Unit 204, Methuen, MA 01844-7149 | 2019-11-18 |
1376194142 | Nicholas Davenport Biscardi | Nurse Practitioner | 6 Wells St, Gloucester, MA 01930-3423 | 2019-09-24 |
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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.