VICTORIA DENE CLARK (NPI# 1417361502) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1417361502 |
Entity Type | Individual |
Full Name | VICTORIA DENE CLARK |
Practice Address |
24111 Southfield Rd Southfield MI 48075-2841 |
Mailing Address |
30760 Nelson Circle Westland MI 48186 |
Practice Telephone | 2485578800 |
Practice Fax Number | 2485578860 |
Enumeration Date | 2014-06-17 |
Last Update Date | 2014-11-20 |
Gender Code | F |
Is Sole Proprietor | Y |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 363LA2200X |
Nurse Practitioner Specialization: Adult Health |
4704276153 | MI | Physician Assistants & Advanced Practice Nursing Providers |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1609399427 | Victoria Regina Clark | Physician Assistant | 113 Sutton Dr, Berkeley Heights, NJ 07922-2510 | 2017-07-24 |
1730567082 | Victoria Ann Clark | Counselor | 4300 Sw Sw 13th Street, Gainesville, FL 32608 | 2015-05-07 |
1487073052 | Victoria Clark | Counselor | 1319 Brown St, Martinez, CA 94553-1924 | 2014-04-10 |
1215588462 | Victoria Clark | Advanced Practice Midwife | 1600 Haddon Ave, Camden, NJ 08103-3101 | 2019-09-27 |
1972153757 | Victoria Ann Clark | Counselor | 1840 Bragaw St Ste 110, Anchorage, AK 99508-3463 | 2019-09-13 |
1205494275 | Victoria Clark | Occupational Therapist | 550 Saint Charles Dr Ste 100, Thousand Oaks, CA 91360-3969 | 2019-06-04 |
1568924082 | Victoria Clark | Registered Nurse | 125 W Mission Ave, Escondido, CA 92025-1720 | 2019-04-03 |
1831614494 | Victoria Lea Clark | Case Manager/Care Coordinator | 107 Cranes Roost Ct, Elizabethtown, KY 42701-3650 | 2017-08-04 |
1053764076 | Victoria Clark | Physician Assistant | 1 Robert Wood Johnson Pl, Room 396, New Brunswick, NJ 08901-1928 | 2016-07-14 |
1346699733 | Victoria E Clark | Neurological Surgery | Massachusetts General Hospital, 55 Fruit St., Boston, MA 02114 | 2016-06-07 |
Street Address |
24111 SOUTHFIELD RD |
City | SOUTHFIELD |
State | MI |
Zip Code | 48075-2841 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1861437410 | Annette L Wahl | Nurse Practitioner | 24111 Southfield Rd, Southfield, MI 48075-2817 | 2006-06-18 |
1851855845 | Chinyere Mercy Mbamah | Nurse Practitioner | 24111 Southfield Rd, Southfield, MI 48075-2841 | 2019-01-24 |
1043763477 | Joy Besiime | Nurse Practitioner | 24111 Southfield Rd, Southfield, MI 48075-2841 | 2016-08-02 |
1568843811 | Care First Group Living & In Home Services, Inc. | In Home Supportive Care | 24111 Southfield Rd, Southfield, MI 48075-2841 | 2015-06-12 |
1932525524 | Toyia Novak | Nurse Practitioner | 24111 Southfield Rd, Southfield, MI 48075-2841 | 2014-03-06 |
1427471291 | Alishia Harris-diouf | Nurse Practitioner | 24111 Southfield Rd, Southfield, MI 48075-2841 | 2014-01-29 |
1437583465 | Hardev Kaur Shergill | Nurse Practitioner | 24111 Southfield Rd, Southfield, MI 48075-2841 | 2013-08-27 |
1548514177 | Sarah Collins | Nurse Practitioner | 24111 Southfield Rd, Southfield, MI 48075-2841 | 2012-11-05 |
1346549409 | Michigan Wound Care and Hyperbaric Institute PC | Nurse Practitioner | 24111 Southfield Rd, Southfield, MI 48075-2841 | 2011-03-15 |
1174822233 | Michigan Wound Care and Hyperbaric Institute PC | Nurse Practitioner | 24111 Southfield Rd, Southfield, MI 48075-2841 | 2011-03-15 |
Find all providers in the same location |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1851900054 | K&b Medical Wigs, LLC | Durable Medical Equipment & Medical Supplies | 16250 Northland Dr. Ste 221, Southfield, MI 48075 | 2020-07-24 |
1790300390 | Julian Jeberaeel | Radiology | 2250 Providence, Southfield, MI 48075 | 2020-06-10 |
1265056410 | Husein Yusuf Husein | Podiatrist | Ascension Providence Hospital Southfield Campus, 16001 W. Nine Mile Rd. Depaul 2nd Floor, Southfield, Mi, MI 48075 | 2020-06-03 |
1952945420 | Paris Straughter | Nurse Practitioner | 18438 Onyx St, Southfield, MI 48075 | 2019-10-29 |
1811467657 | Medicine Man Medical, Pllc | Physical Medicine & Rehabilitation | 25130 Southfield Road, Suite #210, Southfield, MI 48075 | 2018-12-04 |
1447725528 | Rommel Ramos Perez | Physical Therapist | 26017 Greenfield Rd., Southfield, MI 48075 | 2018-10-04 |
1073009627 | Jacqueline Venora Goodgame | Licensed Practical Nurse | 4000 Town Ctr, Southfield, MI 48075 | 2018-07-06 |
1043712532 | Hollie Marie Maltese | Physical Therapy Assistant | 22255 Greenfiled 118, Southfield, MI 48075 | 2018-03-01 |
1932601481 | Katie Marie Mccormack | Occupational Therapist | 16001 West Nine Mile Rd., Southfield, MI 48075 | 2018-03-01 |
1801304241 | Absolute Hc LLC | Physical Therapist | 23461 Greenfield Rd Ste 200b, Southfield, MI 48075 | 2018-01-19 |
Find all providers in zip 48075 |
Taxonomy Code | 363LA2200X |
Grouping | Physician Assistants & Advanced Practice Nursing Providers |
Classification | Nurse Practitioner |
Specialization | Adult Health |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1043726144 | Np Provision, LLC | Nurse Practitioner | 23077 Greenfield Rd., Suite 479, Southfield, MI 48075-3769 | 2017-12-27 |
1144579798 | Nichol Lynn Tufts | Nurse Practitioner | 19933 West 13 Miles Rd, Southfield, MI 48076 | 2012-08-29 |
1962440693 | Janet Lynn Safawi | Nurse Practitioner | Southfield Clinic, 29355 Northwestern Hwy Ste 200, Southfield, MI 48034 | 2006-06-03 |
1841282753 | Laynette Goudy-egger | Nurse Practitioner | 29556 Southfield Rd, Suite 200, Southfield, MI 48076-2021 | 2005-08-17 |
1710547823 | Christina Akaraz | Nurse Practitioner | 29877 Telegraph Rd, Southfield, MI 48034-1332 | 2019-06-20 |
1619467677 | Timothy Gates LLC | Nurse Practitioner | 16250 Northland Dr Ste 369, Southfield, MI 48075-5208 | 2018-05-15 |
1245764737 | Sharon Blackshire-tubie | Nurse Practitioner | 20755 Greenfield Rd, #203, Southfield, MI 48075-5403 | 2017-04-12 |
1932525524 | Toyia Novak | Nurse Practitioner | 24111 Southfield Rd, Southfield, MI 48075-2841 | 2014-03-06 |
1235564402 | Katherine Rose Shaw | Nurse Practitioner | 19933 W 13 Mile Rd, Southfield, MI 48076-1024 | 2013-09-06 |
1326471764 | Timiko Lei Drew | Nurse Practitioner | 23077 Greenfield Rd, Suite 479, Southfield, MI 48075 | 2013-08-20 |
Find all providers in SOUTHFIELD |
City | SOUTHFIELD |
Zip Code | 48075 |
Please comment or provide details below to improve the information on VICTORIA DENE 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.