MRS. JENNIFER GAYLE RIES-CLARK


Address: 8009 W Salter Dr, Peoria, AZ 85382-4440
Phone: 6026638127

MRS. JENNIFER GAYLE RIES-CLARK (NPI# 1619435310) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1619435310
Entity Type Individual
Full Name MRS. JENNIFER GAYLE RIES-CLARK
Credential FNPC
Practice Address 8009 W Salter Dr
Peoria
AZ 85382-4440
Practice Telephone 6026638127
Mailing Telephone 6026638127
Enumeration Date 2019-03-12
Last Update Date 2019-03-12
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 363LF0000X Nurse Practitioner
Specialization: Family
219824 AZ Physician Assistants & Advanced Practice Nursing Providers

Other Provider Identifier

State Issuer Identifier Type Code
AZ ARIZONA ADVANCED PRACTICE LICENCE 219824 01
AZ ARIZONA STATE BOARD OF NURSING RN157294 01

Provider Secondary Practice Location

Address Telephone Number Fax Number
8009 W Salter Dr, Peoria, AZ 853824440 6026638127

Office Location

Street Address 8009 W SALTER DR
City PEORIA
State AZ
Zip Code 85382-4440

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NPI Name Taxonomy Address Enumeration
1205435146 Arizona Ot Solutions LLC Occupational Therapist 7450 W. Karen Lee Lane, Peoria, AZ 85382 2020-10-21
1497380604 Idream Psychiatry Psychiatry & Neurology 8194 West Deer Valley Rd, 106-516, Peoria, AZ 85382 2020-03-08
1770137648 Stefan Cseh Occupational Therapy Assistant 8765 W Keiton Lane #116, Peona, AZ 85382 2019-07-30
1174177422 Assyrian Cultural Foundation of Arizona Homemaker 9163 West Union Hills Drive, Suite 114 and 115, Peoria, AZ 85382 2019-07-25
1073072765 Darby Shipman Physical Therapist 8685 W. Union Hills Drive, Peoria, AZ 85382 2019-03-13
1811483480 Kimberly Ann Cochran Nurse Practitioner 8194 W Deer Valley Rd Ste 106-516, Peoria, AZ 85382 2018-07-07
1831693514 Summa Health Care, PC Family Medicine 8877 W Union Hills Dr Ste 240, Peoria, AZ 85382 2018-03-19
1497258727 Nkemdirim Obiora Nurse Practitioner 7853 West Lone Cactus Drive, Peoria, AZ 85382 2018-03-13
1851893721 Alyssa Michelle Bauman Registered Nurse 20283 N Lake Pleasant Rd Ste 112, Peoria, AZ 85382 2018-03-06
1043767106 Jason Mcaddley Pharmacist 9425 West Union Hills Drive, Peoria, AZ 85382 2016-09-07
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Taxonomy Information

Taxonomy Code 363LF0000X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Nurse Practitioner
Specialization Family

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1881295541 Britney Julia Durst Nurse Practitioner 5905 N Prospect Rd, Peoria, IL 61614-4311 2020-11-07
1598362980 Courtney Klein Nurse Practitioner 1306 N. Berkley Ave, Peoria, IL 61603 2020-10-08
1699390039 Steven Joel Schlink Nurse Practitioner 12920 W Roy Rogers Rd, Peoria, AZ 85383-5334 2020-06-11
1457986929 Chanelle Christine Maclin Nurse Practitioner 504 E Kansas St, Peoria, IL 61603-2554 2020-03-05
1225677495 Michelle Chacon Nurse Practitioner 23201 N 87th Dr, Peoria, AZ 85383-1860 2020-01-05
1689218042 Patricia Nwakaego Ayemoba Nurse Practitioner 16018 N 74th Dr, Peoria, AZ 85382-1810 2019-10-29
1144877267 Eunice Wright Nurse Practitioner 26826 N 85th Dr, Peoria, AZ 85383-3624 2019-08-22
1861057507 Shawnee Renee Fudurich Nurse Practitioner 10230 W Happy Valley Pkwy Ste 100, Peoria, AZ 85383-4255 2019-05-08
1265096895 Razel Espiritu Hernandez Nurse Practitioner 25435 N 115th Ave, Peoria, AZ 85383-9789 2019-04-29
1679038749 Darnell L Keys Nurse Practitioner 12799 W Lowden Rd, Peoria, AZ 85383-7805 2019-02-04
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Competitor

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City PEORIA
Zip Code 85382

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Dataset Information

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.

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