DEANNA R CLARK (NPI# 1477003366) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1477003366 |
| Entity Type | Individual |
| Full Name | DEANNA R CLARK |
| Credential | CFNP |
| Practice Address |
4304 Carlisle Blvd Ne Albuquerque NM 87107-4811 |
| Practice Telephone | 5058881075 |
| Practice Fax Number | 5058881082 |
| Mailing Telephone | 5058881075 |
| Mailing Fax Number | 5058881082 |
| Enumeration Date | 2016-10-04 |
| Last Update Date | 2018-06-22 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
CNP-03049 | NM | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578012514 | Deanna Clark | Registered Nurse | 1539 Stone Rd, Rochester, NY 14615-1516 | 2016-10-03 |
| 1871641084 | Deanna Clark | Speech-Language Pathologist | 4021 Iona Cir, Anchorage, AK 99507-3341 | 2007-01-08 |
| 1801347711 | Deanna Deloney Clark | Occupational Therapy Assistant | 2230 Ashley Crossing Dr, Charleston, SC 29414-5700 | 2016-10-17 |
| 1013145093 | Deanna Carol Clark | Counselor | 911 E Colorado Blvd Ste 200, Pasadena, CA 91106-1773 | 2009-06-29 |
| Street Address |
4304 CARLISLE BLVD NE |
| City | ALBUQUERQUE |
| State | NM |
| Zip Code | 87107-4811 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619938677 | Lisa S Noya | Internal Medicine | 4304 Carlisle Blvd Ne, Albuquerque, NM 87107-4811 | 2006-03-30 |
| 1598305989 | Megan Caroline Beaudoin | Physician Assistant | 4304 Carlisle Blvd Ne, Albuquerque, NM 87107-4811 | 2020-01-13 |
| 1033770169 | Linda M Garcia | Physician Assistant | 4304 Carlisle Blvd Ne, Albuquerque, NM 87107-4811 | 2019-06-28 |
| 1437637758 | Justeen A Griego | Registered Nurse | 4304 Carlisle Blvd Ne, Albuquerque, NM 87107-4811 | 2018-07-30 |
| 1609329069 | Briana L Henderson | Physician Assistant | 4304 Carlisle Blvd Ne, Albuquerque, NM 87107-4811 | 2016-08-02 |
| 1336692730 | Destiny C Keller | Physician Assistant | 4304 Carlisle Blvd Ne, Albuquerque, NM 87107-4811 | 2016-08-02 |
| 1730583626 | Pooneh Newton | Physician Assistant | 4304 Carlisle Blvd Ne, Albuquerque, NM 87107-4811 | 2014-10-21 |
| 1760757199 | Drew K Newhoff | General Practice | 4304 Carlisle Blvd Ne, Albuquerque, NM 87107-4811 | 2012-03-19 |
| 1043376346 | Four Humours Healthcare, LLC | Hospitalist | 4304 Carlisle Blvd Ne, Albuquerque, NM 87107-4811 | 2006-12-29 |
| 1770596777 | Stephen C Keller | Physician Assistant | 4304 Carlisle Blvd Ne, Albuquerque, NM 87107-4811 | 2006-08-14 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619589785 | Benjamin Argant | Behavior Technician | 331 Candelaria Road North East Suite A, Albuquerque, NM 87107 | 2020-08-20 |
| 1679138861 | Susan Luna, Lpcc LLC | Counselor | 3221 B Candelaria Ne, Albuquerque, NM 87107 | 2019-05-03 |
| 1407310881 | Eleanor Cloe Tibbetts | Speech-Language Pathologist | 7103 4th St. Nw Chatterbox Speech Therapy, Los Ranchos, NM 87107 | 2019-01-30 |
| 1386174829 | Triple D Medical Transportation, LLC. | Secured Medical Transport (VAN) | 2123 Menaul Blvd Ne Ste B, Albuquerque, NM 87107 | 2017-06-18 |
| 1487100715 | Kayleen Weinandt | Community/Behavioral Health | 3301 Los Arboles Ne, Albuquerque, NM 87107 | 2016-08-28 |
| 1811345549 | Inverse Medical, LLC | Non-emergency Medical Transport (VAN) | 1015 Cottonwood Dr. Suite J, Albuquerque, NM 87107 | 2016-06-03 |
| 1710349220 | Evolv Strong, LLC | Specialist/Technologist | 3201 Candelaria Rd Ne, Albuquerque, NM 87107 | 2016-03-23 |
| 1982072443 | Erik Robinson | Social Worker | 7801 Academy Road, Ne 2-200, Albueruque, NM 87107 | 2015-09-14 |
| 1033505763 | Sam Newmon Ma, Lpcc | Counselor | 320-h Osuna Rd Ne, Suite 4, Albuquerque, NM 87107 | 2015-04-09 |
| 1760896203 | Jocelyn Fiaschetti | Social Worker | 7704 4th Street Nw, Albuquerque, NM 87107 | 2014-06-12 |
| Find all providers in zip 87107 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497354328 | Tracy Bui | Nurse Practitioner | 9200 Timber Ridge Rd Nw, Albuquerque, NM 87120-6278 | 2020-10-21 |
| 1558969253 | Beverly Carter | Nurse Practitioner | 5021 Nelson Pl Nw, Albuquerque, NM 87114-4320 | 2020-10-14 |
| 1932706223 | Rozita Dayani | Nurse Practitioner | 6821 Promenade Ave Ne, Albuquerque, NM 87109-2824 | 2020-10-08 |
| 1730795626 | Jia Wu | Nurse Practitioner | 7124 Marseille Pl Ne, Albuquerque, NM 87122-3328 | 2020-09-17 |
| 1912513870 | Ariel A Nunez | Nurse Practitioner | 500 Walter Street Ne, Suite 216, Lovelace Medical Towers - Clinical Informatics, Albuquerque, NM 87102-2543 | 2020-09-16 |
| 1326652173 | Matthew S Fogel | Nurse Practitioner | 3129 Casa Bonita Dr Ne, Albuquerque, NM 87111-5607 | 2020-08-31 |
| 1467065532 | Amberleigh Morrish | Nurse Practitioner | 2100 George Rd Se # 19012, Albuquerque, NM 87106-5608 | 2020-08-28 |
| 1457962102 | Roxanne Christian | Nurse Practitioner | 1909 Brookhaven Pl Nw, Albuquerque, NM 87120-8006 | 2020-08-14 |
| 1689298879 | Marissa Jenee Simpson | Nurse Practitioner | 4839 Stafford Pl Nw, Albuquerque, NM 87120-3232 | 2020-06-03 |
| 1306465810 | Alice Xiao Arellano | Nurse Practitioner | 13512 Red Yucca Ave Ne, Albuquerque, NM 87111-8226 | 2020-04-14 |
| Find all providers in ALBUQUERQUE | ||||
| City | ALBUQUERQUE |
| Zip Code | 87107 |
Please comment or provide details below to improve the information on DEANNA R 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.