MR. NATHAN BLAINE CLARK (NPI# 1578853883) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1578853883 |
Entity Type | Individual |
Full Name | MR. NATHAN BLAINE CLARK |
Credential | APRN |
Practice Address |
310 W 5th St Benton KY 42025-1102 |
Mailing Address |
300 S 8th St Suite 480w Murray KY 42071-2400 |
Practice Telephone | 2709062444 |
Mailing Telephone | 2709062444 |
Enumeration Date | 2011-04-08 |
Last Update Date | 2011-04-14 |
Gender Code | M |
Is Sole Proprietor | Y |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
3006900 | KY | Physician Assistants & Advanced Practice Nursing Providers |
State | Issuer | Identifier | Type Code |
---|---|---|---|
KY | ARNP LICENSE | 3006900 | 01 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1891150843 | Nathan Clark | Physical Therapy Assistant | 404 Olive St, Atlantic, IA 50022-1363 | 2015-12-17 |
1053664250 | Nathan M Clark | Chiropractor | 597 S Main St Ste A, Ukiah, CA 95482-4988 | 2012-10-25 |
1629684873 | Nathan Clark | Chiropractor | 3030 Sawtelle Blvd, Los Angeles, CA 90066-1408 | 2020-09-22 |
1366097958 | Nathan C Clark | Physical Therapy Assistant | 4617 Austin Bluffs Pkwy, Colorado Springs, CO 80918-2937 | 2019-08-09 |
1932763570 | Nathan Clark | Physical Therapist | 3100 Olympus Blvd Ste 500, Coppell, TX 75019-5473 | 2019-04-29 |
1881172195 | Nathan Edward Clark | Behavioral Analyst | 4433 W Touhy Ave Ste 335, Lincolnwood, IL 60712-1820 | 2018-07-30 |
1699126508 | Nathan Daniel Clark | Specialist/Technologist | 5701 Delhi Rd, Cincinnati, OH 45233-1669 | 2016-06-22 |
1538576798 | Nathan Daniel Clark | Pharmacist | 5100 Library Rd, Bethel Park, PA 15102-2829 | 2014-07-18 |
1588898373 | Nathan A Clark | Podiatrist | 100 Jackson Pike, Gallipolis, OH 45631-1560 | 2009-05-07 |
1528267721 | Nathan Clark | Pharmacy Technician | 280 Exempla Cir, Lafayette, CO 80026-3370 | 2007-07-17 |
Street Address |
310 W 5TH ST |
City | BENTON |
State | KY |
Zip Code | 42025-1102 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1801839477 | Michael Lynn Hayes | Optometrist | 310 W 5th St, Benton, KY 42025-1102 | 2006-06-13 |
1659972115 | Stephanie Lynne Evans | Pharmacist | 310 W 5th St, Benton, KY 42025-1102 | 2020-11-02 |
1255931879 | Rhonda Goins | Pharmacist | 310 W 5th St, Benton, KY 42025-1102 | 2020-11-01 |
1487254496 | Kayla Alexander | Pharmacist | 310 W 5th St, Benton, KY 42025-1102 | 2020-10-28 |
1578005146 | Lauren Nicole Ford | Pharmacist | 310 W 5th St, Benton, KY 42025-1102 | 2016-11-13 |
1306928247 | Wal-mart Stores East, Lp | Technician/Technologist | 310 W 5th St, Benton, KY 42025-1102 | 2006-10-19 |
1437176757 | Wal-mart Stores East Lp | Durable Medical Equipment & Medical Supplies | 310 W 5th St, Benton, KY 42025-1102 | 2006-07-16 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1073862843 | Elisha Dougherty | Pharmacist | 1004 Big Bear Hwy, Benton, KY 42025 | 2012-09-07 |
1730310285 | Benton Chiropractic, Pllc | Chiropractor | 141 Commerce Blvd, Benton, KY 42025 | 2009-07-31 |
1689813594 | Murray Calloway County Public Hospital | Internal Medicine | 543 Powell St, Benton, KY 42025 | 2009-02-17 |
1912159864 | William J Barabas | Physical Therapist | 244 Us Hwy 68 East, Benton, KY 42025 | 2008-10-22 |
1447419031 | Mary Jane Darnell | Occupational Therapy Assistant | 2607 Main Street, Benton, KY 42025 | 2008-06-09 |
1710176540 | Karen Diane Reed | Counselor | 198 Old Symsonia Road, Suite 107, Benton, KY 42025 | 2007-10-17 |
1255475794 | Community Alternatives Kentucky, Inc. | Home Health | 402 Caky Drive, Benton, KY 42025 | 2007-02-17 |
1477605988 | Marshall County Medical Associates | Family Medicine | 145 Vine Street, Benton, KY 42025 | 2007-01-17 |
1376604256 | Marshall County Assn. for Exceptional Children and Adults, Inc | Day Training, Developmentally Disabled Services | 198 Old Symsonia Road, Benton, KY 42025 | 2006-12-13 |
1023111929 | Benton Health Care, LLC | Nurse Practitioner | 414 East 12th Street, Benton, KY 42025 | 2006-09-06 |
Find all providers in zip 42025 |
Taxonomy Code | 363LF0000X |
Grouping | Physician Assistants & Advanced Practice Nursing Providers |
Classification | Nurse Practitioner |
Specialization | Family |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1710525720 | Melanie Mabry | Nurse Practitioner | 11510 State Highway 298, Benton, AR 72019 | 2019-12-20 |
1538625900 | Morgan Dyanne Colson | Nurse Practitioner | 1576 Brookshire Dr, Benton, AR 72019-9547 | 2019-02-11 |
1639648041 | Laurie Jeannette Kerschner | Nurse Practitioner | 166 Wellivers Hill Rd, Benton, PA 17814-8131 | 2018-11-14 |
1790253326 | Seth Alexander Weisheit | Nurse Practitioner | 824 Military Road, Benton, AR 72015 | 2018-11-13 |
1982171484 | Reanna Christine Hargrove | Nurse Practitioner | 2314 Olive Creek Rd, Benton, KY 42025-4208 | 2018-11-01 |
1710474093 | Carmacare Inc | Nurse Practitioner | 2408 Military Rd, Benton, AR 72015-2743 | 2018-04-23 |
1366950693 | Blake Borders | Nurse Practitioner | 222 Bland St, Benton, MO 63736-9206 | 2018-01-22 |
1063920452 | Pamela Ann Bates | Nurse Practitioner | 824 Military Rd, Benton, AR 72015-3347 | 2018-01-19 |
1023525490 | Kortney Kai Spann | Nurse Practitioner | 4110 Darla Dr, Benton, AR 72015-6299 | 2018-01-05 |
1548791510 | Monica Suzanne Williams | Nurse Practitioner | 10676 Hinds Rd, Benton, AR 72019-9442 | 2017-03-22 |
Find all providers in BENTON |
Please comment or provide details below to improve the information on MR. NATHAN BLAINE 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.