GUY MAX CLARK (NPI# 1356907083) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1356907083 |
| Entity Type | Individual |
| Full Name | GUY MAX CLARK |
| Credential | RN |
| Practice Address |
516 E Nizhoni Blvd Gallup NM 87301-5748 |
| Practice Telephone | 5057221000 |
| Mailing Telephone | 5057221000 |
| Enumeration Date | 2019-05-17 |
| Last Update Date | 2019-05-17 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 163WM0705X |
Registered Nurse Specialization: Medical-Surgical |
897468 | TX | Nursing Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215948286 | Guy Charles Clark | Dentist | 3613 New Mexico Highway 528, Suite G, Albuquerque, NM 87114 | 2006-08-11 |
| 1235160789 | Guy Clark | Emergency Medicine | 601 S Concord St Ste 108, Knoxville, TN 37919-3339 | 2006-07-05 |
| 1063574788 | Guy Clark | Internal Medicine | 2419 Castillo St, Santa Barbara, CA 93105-4301 | 2006-12-16 |
| Street Address |
516 E NIZHONI BLVD |
| City | GALLUP |
| State | NM |
| Zip Code | 87301-5748 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326047846 | William Brant Hesidence II | Podiatrist | 516 E Nizhoni Blvd, Gallup, NM 87301-5748 | 2005-07-18 |
| 1205437712 | Maryann T Park | Registered Nurse | 516 E Nizhoni Blvd, Gallup, NM 87301-5748 | 2020-11-03 |
| 1649871054 | Lesley J Legah | Registered Nurse | 516 E Nizhoni Blvd, Gallup, NM 87301-5748 | 2020-11-03 |
| 1659972073 | Carla B Patterson | Registered Nurse | 516 E Nizhoni Blvd, Gallup, NM 87301-5748 | 2020-11-03 |
| 1770183733 | Logan Smolla | Pharmacist | 516 E Nizhoni Blvd, Gallup, NM 87301-5748 | 2020-10-29 |
| 1497355499 | Christopher P Sherman | Registered Nurse | 516 E Nizhoni Blvd, Gallup, NM 87301-5748 | 2020-10-28 |
| 1164022414 | Margaret Krick | Registered Nurse | 516 E Nizhoni Blvd, Gallup, NM 87301-5748 | 2020-10-27 |
| 1780283416 | John Robert Sherwood | Registered Nurse | 516 E Nizhoni Blvd, Gallup, NM 87301-5748 | 2020-10-23 |
| 1366041006 | Tracy Michelle Sherwood | Registered Nurse | 516 E Nizhoni Blvd, Gallup, NM 87301-5748 | 2020-10-23 |
| 1306445473 | Stacey Leigh Cortez | Registered Nurse | 516 E Nizhoni Blvd, Gallup, NM 87301-5748 | 2020-10-20 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154966141 | Karen Marie Acuesta Arboleda | Registered Nurse | 516 E Nizhoni Bld., Gallup, NM 87301 | 2019-11-13 |
| 1811453707 | Kelly Dahn | Respiratory Therapist, Certified | 516 E Hizhoni Blvd, Gallup, NM 87301 | 2019-02-15 |
| 1417411232 | Frances Griego | Registered Nurse | 28b Alma Drive, Gallup, NM 87301 | 2019-01-25 |
| 1891267605 | Hozho Academy | Occupational Therapist | 306 Nm-564, Gallup, NM 87301 | 2018-12-19 |
| 1922514686 | Jjdac, LLC | Ambulance | 208 W Maloney Ave, Gallup, NM 87301 | 2017-12-18 |
| 1508382698 | Katherine L Kuehl | Pharmacist | Walgreens 1870 E Historic Highway 66, Galliup, NM 87301 | 2017-08-21 |
| 1497285001 | Jessica Kate Savant | Registered Nurse | 516 E Nazhoni Blvd, Gallup, NM 87301 | 2017-06-15 |
| 1770013385 | Nicole Aline Pavy | Registered Nurse | 516 E. Nizhioni Blvd, Gallup, NM 87301 | 2017-06-15 |
| 1730612276 | Camie Renee Nelson | Contractor | 121 Bishop Drive, Gallup, NM 87301 | 2017-04-11 |
| 1508216227 | Marriah Silversmith | Technician, Other | 3426 Blue Hill Ave, Gallup, NM 87301 | 2016-06-14 |
| Find all providers in zip 87301 | ||||
| Taxonomy Code | 163WM0705X |
| Grouping | Nursing Service Providers |
| Classification | Registered Nurse |
| Specialization | Medical-Surgical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497245146 | Stephenie Nicole Thomas | Registered Nurse | Gallup Indian Medical Center, 516 E. Nizhoni Blvd, Gallup, NM 87301-5748 | 2018-05-17 |
| 1013251842 | Vicky Gail Dowdy | Registered Nurse | 3197 Blue Hill Ave, Gallup, NM 87301-6969 | 2012-11-16 |
| 1780283416 | John Robert Sherwood | Registered Nurse | 516 E Nizhoni Blvd, Gallup, NM 87301-5748 | 2020-10-23 |
| 1366041006 | Tracy Michelle Sherwood | Registered Nurse | 516 E Nizhoni Blvd, Gallup, NM 87301-5748 | 2020-10-23 |
| 1679188676 | Jordan Ashley Ide | Registered Nurse | 516 E Nizhoni Blvd, Gallup, NM 87301-5748 | 2020-09-15 |
| 1669085957 | Mary Eloise Martin | Registered Nurse | 516 E Nizhoni Blvd, Gallup, NM 87301-5748 | 2020-08-26 |
| 1407468804 | Lori Ann Howard | Registered Nurse | 516 E Nizhoni Blvd, Gallup, NM 87301-5748 | 2020-08-18 |
| 1306464284 | Lavada King | Registered Nurse | 516 E Nizhoni Blvd, Gallup, NM 87301-5748 | 2020-07-08 |
| 1184242133 | Mary Elizabeth Bange | Registered Nurse | 516 E Nizhoni Blvd, Gallup, NM 87301-5748 | 2020-07-07 |
| 1952928806 | Gabrielle Ariana Charleston | Registered Nurse | 516 E Nizhoni Blvd, Gallup, NM 87301-5748 | 2020-06-26 |
| Find all providers in GALLUP | ||||
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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.