DR. KRISTIN L. CLARK (NPI# 1710982756) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1710982756 |
| Entity Type | Individual |
| Full Name | DR. KRISTIN L. CLARK |
| Credential | M.D. |
| Practice Address |
1821 S Webster Ave Green Bay WI 54301-2253 |
| Mailing Address |
5485 W Grande Market Dr Ste C Appleton WI 54913-8430 |
| Practice Telephone | 9204964700 |
| Mailing Telephone | 9207297105 |
| Enumeration Date | 2005-06-16 |
| Last Update Date | 2019-11-26 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207V00000X | Obstetrics & Gynecology | 46761-020 | WI | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | 34577900 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 200 Theda Clark Medical Plz, Ste 130, Neenah, WI 549562790 | 9207297105 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619391059 | Kristin Clark | Registered Nurse | 1229 S. Wheeling Way, Aurora, CO 80012 | 2014-02-05 |
| 1336466283 | Kristin Dumboski Clark | Dentist | 5401 John F Kennedy Blvd, Suite H, North Little Rock, AR 72116-6756 | 2010-04-30 |
| 1164745980 | Kristin Clark | Acupuncturist | 424 Wayne Road, Rochelle, IL 61068-9063 | 2010-03-08 |
| 1932177508 | Kristin Clark | Family Medicine | 5018 Dorsey Hall Dr, Suite 104, Ellicott City, MD 21042-7855 | 2006-03-09 |
| 1982255790 | Kristin Ann Clark | Behavior Technician | 2730 Shadelands Dr Bldg 10, Walnut Creek, CA 94598-2538 | 2019-09-23 |
| 1982252011 | Kristin Michelle Clark | Licensed Practical Nurse | 997 Saint Paul St, Rochester, NY 14605-1051 | 2019-09-02 |
| 1285103762 | Kristin C Clark | Radiology Practitioner Assistant | 975 E 3rd St, Chattanooga, TN 37403-2147 | 2018-11-14 |
| 1275993339 | Kristin Tai Clark | Marriage & Family Therapist | 5150 E Pacific Coast Hwy, Suite 100, Long Beach, CA 90804 | 2016-03-02 |
| 1174918213 | Kristin Clark | Behavioral Analyst | 6 Strathmore Rd, Natick, MA 01760-2419 | 2015-04-06 |
| 1164764585 | Kristin Elise Clark | Anesthesiology | 14700 28th Ave N Ste 20, Plymouth, MN 55447-4876 | 2013-03-24 |
| Street Address |
1821 S WEBSTER AVE |
| City | GREEN BAY |
| State | WI |
| Zip Code | 54301-2253 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821091679 | Jerald P Marifke | Internal Medicine | 1821 S Webster Ave, Green Bay, WI 54301-2253 | 2005-05-24 |
| 1144858713 | Dawn P Mccullough | Nurse Practitioner | 1821 S Webster Ave, Green Bay, WI 54301-2253 | 2020-03-30 |
| 1881230266 | Kasey Jankowski | Physician Assistant | 1821 S Webster Ave, Green Bay, WI 54301-2253 | 2019-11-21 |
| 1699247486 | Erin Joanne Broda | Advanced Practice Midwife | 1821 S Webster Ave, Green Bay, WI 54301-2253 | 2018-12-18 |
| 1467928440 | Ashley Naas | Physical Therapist | 1821 S Webster Ave, Green Bay, WI 54301-2253 | 2018-10-17 |
| 1689167942 | Marissa Adrian | Physician Assistant | 1821 S Webster Ave, Green Bay, WI 54301-2253 | 2018-06-12 |
| 1427585736 | Nicole Will | Physical Medicine & Rehabilitation | 1821 S Webster Ave, Green Bay, WI 54301-2253 | 2017-05-17 |
| 1588111215 | Jennifer Gibbons | Registered Nurse | 1821 S Webster Ave, Green Bay, WI 54301-2253 | 2016-09-11 |
| 1639520414 | Lauren Isabel Useem | Obstetrics & Gynecology | 1821 S Webster Ave, Green Bay, WI 54301-2253 | 2016-06-23 |
| 1437506110 | Jessica Zarzecki | Physician Assistant | 1821 S Webster Ave, Green Bay, WI 54301-2253 | 2016-05-23 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386102465 | Parc Village Dental, LLC | Dentist | 2805 Libal Street, Suite A, Green Bay, WI 54301 | 2019-03-07 |
| 1598229478 | Shaina Marie Conner | Registered Nurse | 835 S Vanburen St, Green Bay, WI 54301 | 2019-01-25 |
| 1093298960 | Brown County | Case Management | 111 N. Jefferson Street, Green Bay, WI 54301 | 2018-09-07 |
| 1639609928 | Frontline Healthcare LLC | Specialist/Technologist, Other | 2221 S. Webster Ave. Suite 270, Greenbay, WI 54301 | 2017-06-19 |
| 1992242606 | Charmaine Rimple | Counselor | 526 South Monroe Avenue, Green Bay, WI 54301 | 2017-01-20 |
| 1962944819 | Rebecca Lucille Reinbold | Registered Nurse | 917 Catherine Street, Green Bay, WI 54301 | 2016-11-09 |
| 1730635061 | Melissa Kristof | Specialist/Technologist, Other | 1821 Sounth Webster Ave., Green Bay, WI 54301 | 2016-08-28 |
| 1255709747 | Vivian Sweetheart Bishop-cook | Counselor | 2920 South Webster Ave, Green Bay, WI 54301 | 2015-09-14 |
| 1881079960 | Chelsi S Weber | Registered Nurse | 2300 Riverside Dr., Ste 204, Green Bay, WI 54301 | 2015-07-30 |
| 1962816371 | Joelle M Hesse | Counselor | 630 Cherry St., Green Bay, WI 54301 | 2014-06-13 |
| Find all providers in zip 54301 | ||||
| Taxonomy Code | 207V00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Obstetrics & Gynecology |
| An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Obstetrics and Gynecology, 2007. http://www.abog.org/. American Osteopathic Board of Obstetrics and Gynecology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Obstetrics and Gynecology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Obstetrics and Gynecology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952626905 | Amy Katherine Schueckler | Obstetrics & Gynecology | 301 N Webster Ave, Green Bay, WI 54301-4815 | 2010-04-01 |
| 1508096017 | Anna J Igler | Obstetrics & Gynecology | 2253 W Mason St Ste 300, Green Bay, WI 54303-4706 | 2009-07-17 |
| 1255364667 | Brian Dale Dobbins | Obstetrics & Gynecology | 2890 Lineville Rd, Green Bay, WI 54313-7202 | 2006-07-09 |
| 1083682876 | Cheryl L Bailey | Obstetrics & Gynecology | 720 S Vanburen St, Suite 101, Green Bay, WI 54301-3504 | 2006-03-09 |
| 1134645542 | Bellin Memorial Hospital | Obstetrics & Gynecology | 2641 Development Dr, Green Bay, WI 54311-4240 | 2017-08-17 |
| 1841672516 | Bellin Memorial Hospital Inc | Obstetrics & Gynecology | 704 S Webster Ave, Suite 100 B, Green Bay, WI 54301-3533 | 2015-06-18 |
| 1902210925 | Ryan D Kuefler | Obstetrics & Gynecology | 720 S Vanburen St, Green Bay, WI 54301-3504 | 2014-06-18 |
| 1649407412 | Amy Van Gheem | Obstetrics & Gynecology | 1715 Dousman St, Green Bay, WI 54303-3211 | 2009-06-18 |
| 1407082381 | Sara Helena Tikkanen Swift | Obstetrics & Gynecology | 2845 Greenbrier Rd, Green Bay, WI 54311 | 2009-06-05 |
| 1457518532 | Jory A Ough | Obstetrics & Gynecology | 2641 Development Dr, Green Bay, WI 54311-4240 | 2008-05-17 |
| Find all providers in GREEN BAY | ||||
Please comment or provide details below to improve the information on DR. KRISTIN L. 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.