JOHNEISHA DENISE CLARK (NPI# 1649827445) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1649827445 |
| Entity Type | Individual |
| Full Name | JOHNEISHA DENISE CLARK |
| Practice Address |
3333 W 20th St Jacksonville FL 32254-1703 |
| Practice Telephone | 9046959145 |
| Mailing Telephone | 9046959145 |
| Enumeration Date | 2019-08-26 |
| Last Update Date | 2019-12-10 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 163W00000X | Registered Nurse | RN9393543 | FL | Nursing Service Providers |
| Y | 363LP0808X |
Nurse Practitioner Specialization: Psych/Mental Health |
APRN11004035 | FL | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
3333 W 20TH ST |
| City | JACKSONVILLE |
| State | FL |
| Zip Code | 32254-1703 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033174495 | Renato R Alcalde | Psychiatry & Neurology | 3333 W 20th St, Jacksonville, FL 32254-1703 | 2006-04-19 |
| 1699315911 | Casey Goss | Nurse Practitioner | 3333 W 20th St, Jacksonville, FL 32254-1703 | 2020-01-14 |
| 1821562570 | Brittnai Johnson | Nurse Practitioner | 3333 W 20th St, Jacksonville, FL 32254-1703 | 2019-01-16 |
| 1679042535 | Amanda Rose Iannotti | Counselor | 3333 W 20th St, Jacksonville, FL 32254-1703 | 2018-11-20 |
| 1356818223 | Patrick Ian Smith | Nurse Practitioner | 3333 W 20th St, Jacksonville, FL 32254-1703 | 2018-10-30 |
| 1457840837 | Donna Margaret Reid Lunsford | Nurse Practitioner | 3333 W 20th St, Jacksonville, FL 32254-1703 | 2018-05-01 |
| 1093256158 | Gretchen Hamm | Counselor | 3333 W 20th St, Jacksonville, FL 32254-1703 | 2017-03-09 |
| 1104292200 | Robin D Belcher-howard | Nurse Practitioner | 3333 W 20th St, Jacksonville, FL 32254-1703 | 2015-08-12 |
| 1952798068 | Cynthia O'brien | Social Worker | 3333 W 20th St, Jacksonville, FL 32254-1703 | 2015-04-16 |
| 1114317187 | Karen Villanueva | Counselor | 3333 W 20th St, Jacksonville, FL 32254-1703 | 2015-01-29 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730673385 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 1301 W Palm Ave Ste 210, Jacksonville, FL 32254 | 2018-06-18 |
| 1578072112 | Jules M Jean-pierre | Counselor | 2392 North Edgewood Avenue, Jacksonville, FL 32254 | 2017-09-27 |
| 1356869051 | Volaura Shanae Anderson | Counselor | 590 Ellis Rd, Jacksonville, FL 32254 | 2017-09-01 |
| 1962928291 | Angel Spivie | Counselor | 590 Ellis Road South Building 4, Jacksonville, FL 32254 | 2017-08-18 |
| 1376072777 | Tarkeshia Shuman | Contractor | 3150 Broadway Ave, Jacksoville, FL 32254 | 2017-06-08 |
| 1770931636 | Mamie Faith Peterson-mclaurn | Home Health | 2747 Sophia St, Jax, FL 32254 | 2016-06-01 |
| 1760803373 | Marian Lavonne Jones | Custodial Care Facility | 3501 Centerhill Dr. North, Jacksonville, FL 32254 | 2013-12-27 |
| 1659543981 | Monique Bosque-perez | Family Medicine | 781 Edgewood Ave N, Ufjp Commonwealth Family Practice, Jacksonville, FL 32254 | 2008-03-26 |
| 1508906652 | James Keith Riesz | Physical Therapist | 800 Lomax Street, Suite 105, Jacksonville, FL 32254 | 2007-02-07 |
| 1003903865 | Sabrina F Sessions | Pharmacist | 5050 Edgewood Court, Jacksonville, FL 32254 | 2006-10-05 |
| Find all providers in zip 32254 | ||||
| Taxonomy Code | 363LP0808X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Psych/Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720691843 | Eralene Manangan | Nurse Practitioner | 4205 Belfort Rd Ste 4030, Jacksonville, FL 32216-1475 | 2020-08-28 |
| 1306456025 | Richard Mercer | Nurse Practitioner | 3545 Saint Johns Bluff Rd S Ste 137, Jacksonville, FL 32224-2682 | 2020-08-06 |
| 1467060434 | Rebecca Bertone | Nurse Practitioner | 8540 Turkey Oaks Dr S, Jacksonville, FL 32277-2920 | 2020-07-16 |
| 1861018616 | Octavia J Robertson | Nurse Practitioner | 3562 Boone Park Ave, Jacksonville, FL 32205-8433 | 2020-06-17 |
| 1902428568 | Kimberly J Grant | Nurse Practitioner | 8680 Baymeadows Rd E Apt 1413, Jacksonville, FL 32256-4002 | 2020-05-17 |
| 1447710900 | Shannska Atis | Nurse Practitioner | 580 W 8th St Fl II5, Jacksonville, FL 32209-6533 | 2019-03-21 |
| 1811462237 | Dzenefa Ramic | Nurse Practitioner | 10175 Fortune Pkwy Unit 206, Jacksonville, FL 32256-6748 | 2018-10-11 |
| 1851871024 | Shakhia Grant | Nurse Practitioner | 3636 University Blvd S Ste B, Jacksonville, FL 32216-4223 | 2018-08-17 |
| 1295230845 | Lacey Cawthron | Nurse Practitioner | 8130 Baymeadows Cir W Ste 109, Jacksonville, FL 32256-1837 | 2018-03-27 |
| 1083116107 | Kbn Healthcare, Pllc | Nurse Practitioner | 9471 Baymeadows Rd Ste 3, Jacksonville, FL 32256-7932 | 2018-03-05 |
| Find all providers in JACKSONVILLE | ||||
| City | JACKSONVILLE |
| Zip Code | 32254 |
Please comment or provide details below to improve the information on JOHNEISHA DENISE 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.