MR. MARK ALLEN CLARK (NPI# 1407903693) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1407903693 |
| Entity Type | Individual |
| Full Name | MR. MARK ALLEN CLARK |
| Practice Address |
111 Park Hill Dr # A Fredericksburg VA 22401-3357 |
| Mailing Address |
22445 Conservancy Dr Ashburn VA 20148-8068 |
| Practice Telephone | 5403681044 |
| Mailing Telephone | 5403681044 |
| Mailing Fax Number | 5403681033 |
| Enumeration Date | 2007-01-03 |
| Last Update Date | 2012-11-07 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LP0200X |
Nurse Practitioner Specialization: Pediatrics |
0024166868 | VA | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912324351 | Mark Clark | Podiatrist | 2300 Coronado Rd, Pueblo, CO 81003-1840 | 2014-03-24 |
| 1710265160 | Mark Clark | Technician, Other | 6646 Highway 50, Gerald, MO 63037-2700 | 2011-08-02 |
| 1215255682 | Mark P Clark | Counselor | 11 Brandywine Dr, Cincinnati, OH 45246-3809 | 2010-05-11 |
| 1609006022 | Mark H. Clark | Pharmacist | 2901 N Dallas Parkway, Suite 420, Plano, TX 75093 | 2009-07-20 |
| 1588856827 | Mark Brian Clark | Registered Nurse | 3420 Box Elder, Evergreen, CO 80439-7841 | 2007-08-10 |
| 1154549061 | Mark W Clark | Nurse Anesthetist, Certified Registered | 1201 First St, Kennett, MO 63857 | 2007-04-23 |
| 1720119167 | Mark Clark | Counselor | 1366 W Indian Hills Dr Unit 69, Saint George, UT 84770-1885 | 2007-03-08 |
| 1205989605 | Mark Daniel Clark | Anesthesiology | 3735 Norton Hills Rd, Norton Shores, MI 49441-4469 | 2007-01-19 |
| 1447352828 | Mark Wayne Clark | Dentist | G-3550 Flushing Rd, Flint, MI 48504 | 2006-09-05 |
| 1407958291 | Mark Clark | Family Medicine | 7477 S State Rd, Goodrich, MI 48438-8745 | 2006-09-02 |
| Street Address |
111 PARK HILL DR # A |
| City | FREDERICKSBURG |
| State | VA |
| Zip Code | 22401-3357 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992313415 | Amanda Dodd | Behavior Technician | 1411 Princess Anne, Fredericksburg, VA 22401 | 2020-07-21 |
| 1215567326 | Britteny Whitaker | Behavior Technician | 1411 Princess Ann, Fredericksburg, VA 22401 | 2020-01-17 |
| 1396389433 | Ashley Stanevich | Behavior Technician | 1411 Princess Anne Lane, Fredericksburg, VA 22401 | 2019-11-01 |
| 1265074231 | Anna Kelleher | Behavior Technician | 1411 Princess Anna St, Frericksburg, VA 22401 | 2019-10-11 |
| 1649824152 | Zaan Z Ali | Audiologist | 1708 Fall Hill Ave Suite 100, Fredericksburg, VA 22401 | 2019-08-01 |
| 1790342426 | Michael Williams Jr. | Physician Assistant | 411 B Park Hill Dr, Frederickburg, VA 22401 | 2019-05-29 |
| 1285290965 | Ann Damalie Namabiro | Behavior Technician | 1411 Princess Ann Street, Fredericksburg, VA 22401 | 2019-05-17 |
| 1922579630 | Primary and Urgent Care LLC | Family Medicine | Primary and Urgent Care LLC, 2306 Plank Road Ste 100, Fredericksburg, VA 22401 | 2018-12-07 |
| 1003323056 | Mariah Mazzariello | Behavior Technician | 1411 Princess Anne Stree, Fredericksburg, VA 22401 | 2017-12-29 |
| 1336655281 | Hina Zafar | Behavior Technician | 1411 Princess Anne St., Fredericksburg, VA 22401 | 2017-12-14 |
| Find all providers in zip 22401 | ||||
| Taxonomy Code | 363LP0200X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Pediatrics |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629199815 | Kelly Schrock Osborne | Nurse Practitioner | 2632 Salem Church Rd, Fredericksburg, VA 22407-6484 | 2007-04-03 |
| 1629688874 | Amanda Eve Pringle | Nurse Practitioner | 4550 Empire Ct, Fredericksburg, VA 22408-1939 | 2020-08-03 |
| 1326699307 | Ashley Mangus | Nurse Practitioner | 4532 Plank Rd, Fredericksburg, VA 22407-0139 | 2019-09-22 |
| 1033676150 | Ruth Christine Penny | Nurse Practitioner | 2632 Salem Church Rd, Fredericksburg, VA 22407-6484 | 2019-02-25 |
| 1962871137 | Heather Marie Fedak | Nurse Practitioner | 10600 Spotsylvania Ave, Fredericksburg, VA 22408-2637 | 2015-09-17 |
| 1518365881 | Jennifer Eaton | Nurse Practitioner | 10600 Spotsylvania Ave, Fredericksburg, VA 22408-2637 | 2014-12-18 |
| 1962844969 | Gabrielle Irene Le Sage | Nurse Practitioner | 4550 Empire Ct, Fredericksburg, VA 22408-1939 | 2013-07-19 |
| 1679847073 | Kathleen Beckman | Nurse Practitioner | 4550 Empire Ct, Fredericksburg, VA 22408-1939 | 2012-03-02 |
| 1114149648 | Jeanne M Burns | Nurse Practitioner | 20 Plantation Dr, Suite 105, Fredericksburg, VA 22406-7400 | 2007-05-03 |
| 1033233606 | Laura Powell | Nurse Practitioner | 331 Park Hill Dr, Fredericksburg, VA 22401-3375 | 2007-03-19 |
| Find all providers in FREDERICKSBURG | ||||
| City | FREDERICKSBURG |
| Zip Code | 22401 |
Please comment or provide details below to improve the information on MR. MARK ALLEN CLARK.
| 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.