CAROL D. CLARK (NPI# 1457423055) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1457423055 |
| Entity Type | Individual |
| Full Name | CAROL D. CLARK |
| Credential | ARNP, BC |
| Practice Address |
15051 Shell Point Blvd Fort Myers FL 33908-1639 |
| Practice Telephone | 2394542146 |
| Practice Fax Number | 2394542111 |
| Mailing Telephone | 2394542146 |
| Mailing Fax Number | 2394542111 |
| Enumeration Date | 2006-11-15 |
| Last Update Date | 2020-01-30 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LG0600X |
Nurse Practitioner Specialization: Gerontology |
ARNP9191162 | FL | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336520295 | Carol H Clark | Psychologist | 210 Lowry St, Kerrville, TX 78028-5274 | 2015-06-16 |
| 1669656450 | Carol T Clark | Case Management | 300 East Walnut, Suite 200, Pasadena, CA 91101 | 2007-12-28 |
| 1477606044 | Carol L Clark | Counselor | 11651 W Biscayne Canal Rd, Miami, FL 33161-6132 | 2007-01-18 |
| 1053343681 | Carol Shelby Clark | Occupational Therapist | 1647 Mallory Ln, Suite 103, Brentwood, TN 37027-2909 | 2006-07-06 |
| 1649734310 | Carol Riley Clark | Pharmacist | 621 Commerce St, Earle, AR 72331-1616 | 2019-01-28 |
| 1265938302 | Carol Clark | Counselor | 2311 E 98th St, Chicago, IL 60617-4842 | 2018-04-05 |
| 1215441936 | Carol Clark | Case Manager/Care Coordinator | 1095 Sugarview Dr, Sheridan, WY 82801-5386 | 2017-11-17 |
| 1255783940 | Carol Clark | Social Worker | 3125 Poplarwood Ct, Raleigh, NC 27604-1084 | 2016-07-06 |
| 1235503004 | Carol Jones Clark | Speech-Language Pathologist | 550 Roselawn Ave E, Maplewood, MN 55117-2120 | 2015-11-17 |
| 1790192144 | Carol Clark | Massage Therapist | 10 N Roselle Rd, Roselle, IL 60172-1592 | 2014-07-17 |
| Street Address |
15051 SHELL POINT BLVD |
| City | FORT MYERS |
| State | FL |
| Zip Code | 33908-1639 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235109422 | Claude Degraff | Family Medicine | 15051 Shell Point Blvd, Fort Myers, FL 33908-1639 | 2006-01-23 |
| 1932766953 | The Christian & Missionary Alliance Foundation Inc | Home Health | 15051 Shell Point Blvd, Fort Myers, FL 33908-1639 | 2019-05-24 |
| 1740759844 | The Christian & Missionary Alliance Foundation Inc | Nursing Care | 15051 Shell Point Blvd, Fort Myers, FL 33908-1639 | 2018-11-19 |
| 1801322839 | Murilo Jorge Lima | Family Medicine | 15051 Shell Point Blvd, Fort Myers, FL 33908-1639 | 2017-05-11 |
| 1699201194 | Rocio Campbell | Nurse Practitioner | 15051 Shell Point Blvd, Fort Myers, FL 33908-1639 | 2017-05-04 |
| 1366837049 | Kathy Thompson | Family Medicine | 15051 Shell Point Blvd, Fort Myers, FL 33908-1639 | 2015-03-31 |
| 1033534003 | Lewis Thomas Caldrone Jr. | Nurse Practitioner | 15051 Shell Point Blvd, Fort Myers, FL 33908-1639 | 2014-02-27 |
| 1780817734 | Rebecca Kimpel | Internal Medicine | 15051 Shell Point Blvd, Fort Myers, FL 33908 | 2009-08-25 |
| 1629263249 | Susan L. Moran | Nurse Practitioner | 15051 Shell Point Blvd, Fort Myers, FL 33908 | 2007-09-06 |
| 1326265836 | Yaw Adu-sarkodie | Pharmacist | 15051 Shell Point Blvd, Fort Myers, FL 33908-1639 | 2007-04-19 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760081806 | 1 Recovery | Community/Behavioral Health | 111 Daniels Dr, Fort Myers, FL 33908 | 2020-10-20 |
| 1457916462 | Avipharm, LLC | Pharmacy | 7669 Calistoble Loop, 2nd Floor, Fort Myers, FL 33908 | 2019-05-06 |
| 1013492289 | Craig M Stein | Pharmacist | 15236 Tropic Bird Court, Fort Myers, FL 33908 | 2018-10-03 |
| 1730665167 | Kyndra Lynn Petrick | Psychiatry & Neurology | 8560 Big Mangrove Dr, Fort Myers, FL 33908 | 2018-07-18 |
| 1447757547 | Douglas L Jarrett | Nurse Practitioner | 16261 Bass Rd Suite 300, Fort Myers, FL 33908 | 2018-04-06 |
| 1447754825 | Luis Daniel Ramos | General Practice | 15590 Ocean Walk Cir Apt 201, Fort Myers, FL 33908 | 2018-03-21 |
| 1619497062 | Vanesa Paola Vaquer | Dentist | 18070 S Tamiami Trl Ste 101, Fort Myers, FL 33908 | 2017-06-26 |
| 1962859603 | Teresa Ruiz | Behavior Technician | 15081 Woodrich Bend Ct Apt 416, Fort Myers, FL 33908 | 2016-05-23 |
| 1669865721 | Elena B. Alexiev | Dentist | 18070 S. Tamiami Trail, #101, Fort Myers, FL 33908 | 2015-03-13 |
| 1134488919 | Cecelia Anne Collins | Dietitian, Registered | 9215 Calle Arragon Avenue, Unit 205, Fort Myers, FL 33908 | 2012-05-14 |
| Find all providers in zip 33908 | ||||
| Taxonomy Code | 363LG0600X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Gerontology |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528679560 | Leopoldo Nazario | Nurse Practitioner | 3727 Tilbor Cir, Fort Myers, FL 33916-8043 | 2020-08-13 |
| 1124651344 | Tyler William Jones | Nurse Practitioner | 11770 Timbermarsh Ct, Fort Myers, FL 33913-7984 | 2020-02-17 |
| 1477069516 | Deborahlin Huxtable | Nurse Practitioner | 2830 Winkler Ave Ste 207, Fort Myers, FL 33916-9301 | 2017-12-27 |
| 1417331083 | Elizabeth Larson | Nurse Practitioner | 9025 Pomelo Rd W, Fort Myers, FL 33967-3723 | 2015-07-14 |
| 1144421462 | Practitioner Services, Inc | Nurse Practitioner | 8931 Falcon Pointe Loop, Fort Myers, FL 33912-1474 | 2007-05-31 |
| 1245883925 | Monica Cristina Skerski | Nurse Practitioner | 9160 Forum Corporate Pkwy, Fort Myers, FL 33905-7805 | 2019-07-22 |
| 1164907820 | Cassandra Slota | Nurse Practitioner | 2531 Cleveland Ave, Fort Myers, FL 33901-4900 | 2018-09-28 |
| 1114472842 | Marsha Wright | Nurse Practitioner | 13685 Doctors Way, Suite 170, Fort Myers, FL 33912-4336 | 2016-08-23 |
| 1467812768 | Talonda Williams | Nurse Practitioner | 13813 Metro Pkwy, Fort Myers, FL 33912-4343 | 2016-02-29 |
| 1477960888 | Deetta L Debault | Nurse Practitioner | 2232 Grand Ave, Fort Myers, FL 33901-3717 | 2014-07-17 |
| Find all providers in FORT MYERS | ||||
| City | FORT MYERS |
| Zip Code | 33908 |
Please comment or provide details below to improve the information on CAROL D. 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.