MRS. THERESA ANN CLARK (NPI# 1548893506) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1548893506 |
| Entity Type | Individual |
| Full Name | MRS. THERESA ANN CLARK |
| Credential | FNP-BC |
| Practice Address |
420 N Main St Middlebury IN 46540-8985 |
| Mailing Address |
69014 Tamarack Rd Walkerton IN 46574-9735 |
| Practice Telephone | 5748253400 |
| Enumeration Date | 2020-02-18 |
| Last Update Date | 2020-07-21 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
28108427A | IN | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588118665 | Theresa Clark | Licensed Practical Nurse | 6541 Furnace Rd, Ontario, NY 14519-9701 | 2016-08-07 |
| 1003056383 | Theresa Carlisle Clark | Registered Nurse | 1900 Carriage Dr, Phenix City, AL 36867-2116 | 2009-02-26 |
| 1548441710 | Theresa M. Clark | Marriage & Family Therapist | 5 Colony Street, Suites 301/303, Meriden, CT 06451-3272 | 2007-11-16 |
| 1972700912 | Theresa Marie Clark | Counselor | 108 E 12th St, Suite 1, Hays, KS 67601-3668 | 2007-07-02 |
| 1013120948 | Theresa S. Clark | Dietitian, Registered | 530 Noel Ave, Hopkinsville, KY 42240-1386 | 2007-05-07 |
| 1457688384 | Theresa Clark | Marriage & Family Therapist | 1800 Gravenstein Hwy N, Sebastopol, CA 95472-2607 | 2009-11-13 |
| 1104079839 | Theresa Clark | Registered Nurse | 2495 Shreveport Hwy, Pineville, LA 71360-4044 | 2008-10-26 |
| 1659520799 | Theresa Clark | Occupational Therapy Assistant | 2300 Great Lakes Dr, Dyer, IN 46311-1917 | 2008-09-12 |
| 1104015155 | Theresa L Clark | Psychiatry & Neurology | 777 Bannock St, Denver, CO 80204-4507 | 2007-10-16 |
| 1528104650 | Theresa Ross Clark | Internal Medicine | 2067 W Vista Way, Suite 200, Vista, CA 92083-6031 | 2007-01-29 |
| Street Address |
420 N MAIN ST |
| City | MIDDLEBURY |
| State | IN |
| Zip Code | 46540-8985 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104312172 | Deborah Carol Nethercutt | Nurse Practitioner | 226 W Us Highway 20, Middlebury, IN 46540 | 2018-07-02 |
| 1699277160 | Playful Healing, Inc. | Clinic/Center | 300 Wayne Street, Suite A, Middlebury, IN 46540 | 2018-03-01 |
| 1932648839 | Greta Slabach | Prevention Professional | 205 Southern Cross Dr, Middlebury, IN 46540 | 2017-02-13 |
| 1043460652 | Patricia Sue Berry | Licensed Practical Nurse | 303 Twin Oaks Dr., Middlebury, IN 46540 | 2008-09-19 |
| 1629136536 | Eunice Munn | Social Worker | 106 East Berry Street, Middlebury, IN 46540 | 2006-12-04 |
| 1750354890 | Donald L Munn | Marriage & Family Therapist | 106 E Berry St, Middlebury, IN 46540 | 2006-02-09 |
| 1629524988 | Firefly Home Care LLC | In Home Supportive Care | 100 South Main Street, Middlebury, IN 46540 | 2016-08-28 |
| 1396803805 | Donald Munn | Social Worker | 106 East Berry Street, Middlebury, IN 46540 | 2006-12-05 |
| 1306869144 | G. Weldon Friesen | Family Medicine | 206 W Warren St, Middlebury, IN 46540-0459 | 2006-07-25 |
| 1790707974 | Elizabeth B Gingrich | Family Medicine | 206 W. Warren St, Middlebury, IN 46540-0459 | 2006-07-24 |
| Find all providers in zip 46540 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992302517 | Renee Lynnette Hylkema | Nurse Practitioner | 402 Skyview Dr, Middlebury, IN 46540-9567 | 2020-10-06 |
| 1104312172 | Deborah Carol Nethercutt | Nurse Practitioner | 226 W Us Highway 20, Middlebury, IN 46540 | 2018-07-02 |
| 1487052593 | Ania Mortier | Nurse Practitioner | 102 A Court St, Middlebury, VT 05753 | 2014-12-06 |
| 1174939839 | Brian Pervis | Nurse Practitioner | 900 Straits Tpke Ste 205d, Middlebury, CT 06762-2800 | 2014-07-02 |
| 1295162063 | Kathleen Lombard | Nurse Practitioner | 44 Collins Dr Ste 202, Middlebury, VT 05753-8502 | 2013-10-10 |
| 1144209016 | Leslie Gerdinier Orelup | Nurse Practitioner | 44 Collins Dr, Suite 201, Middlebury, VT 05753-8528 | 2006-01-10 |
| 1619451770 | Kate Shaper | Nurse Practitioner | 1330 Exchange St Ste 201, Middlebury, VT 05753-4464 | 2018-09-24 |
| 1750873345 | Gailya Nicole Go | Nurse Practitioner | 1155 N 1200 W, Middlebury, IN 46540-9372 | 2018-05-31 |
| 1649785163 | Kelley Elwell | Nurse Practitioner | 104 Porter Dr, Middlebury, VT 05753-8527 | 2017-12-06 |
| 1295253490 | Julie Anne Paston | Nurse Practitioner | 1155 N 1200 W, Middlebury, IN 46540-9372 | 2017-09-07 |
| Find all providers in MIDDLEBURY | ||||
| City | MIDDLEBURY |
| Zip Code | 46540 |
Please comment or provide details below to improve the information on MRS. THERESA ANN 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.