MRS. NICOLE MARIE CLARK (NPI# 1720312820) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1720312820 |
| Entity Type | Individual |
| Full Name | MRS. NICOLE MARIE CLARK |
| Other Name | MISS NICOLE MARIE SORCE |
| Credential | M.S. R.D. |
| Practice Address |
2 Crescent Park West Nutrition Services Warren PA 16365 |
| Practice Telephone | 8147234973 |
| Mailing Telephone | 8147234973 |
| Enumeration Date | 2009-09-23 |
| Last Update Date | 2009-09-23 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 132700000X | Dietary Manager | Dietary & Nutritional Service Providers | ||
| Y | 133V00000X | Dietitian, Registered | 1004345 | NY | Dietary & Nutritional Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396344826 | Nicole Clark | Home Health Aide | 1024 E 26th Ave, Columbus, OH 43211-2127 | 2020-10-26 |
| 1386106375 | Nicole Clark | Prosthetist | 100 N Burke Ave, Long Beach, MS 39560-4605 | 2019-04-01 |
| 1023513637 | Nicole Elizabeth Clark | Counselor | 3650 Ne Mallory Ave Apt 309, Portland, OR 97212-3086 | 2018-03-26 |
| 1619486834 | Nicole Clark | Registered Nurse | N4093 Keehn Rd, Winter, WI 54896-7312 | 2017-09-20 |
| 1285182022 | Nicole Michelle Clark | Social Worker | 1349 East Stroop Road, Dayton, OH 45429-4925 | 2016-09-21 |
| 1871968768 | Nicole Clark | Specialist/Technologist | 332 Wilson Dr, Bloomfield, IN 47424-1054 | 2015-12-03 |
| 1598165144 | Nicole Janine Clark | Behavioral Analyst | 1787 Village Ln N, Wantagh, NY 11793-3228 | 2014-09-02 |
| 1841609484 | Nicole Tm Clark | Emergency Medicine | 267 Ocean Ave, Portland, ME 04103-5707 | 2014-08-07 |
| 1851445670 | Nicole Ann Clark | Social Worker | 2051 S State St, Ann Arbor, MI 48104-4607 | 2007-01-22 |
| 1982767604 | Nicole Christine Clark | Licensed Practical Nurse | 241 Lorraine Ave, Syracuse, NY 13210-3229 | 2006-12-18 |
| Street Address |
2 CRESCENT PARK WEST NUTRITION SERVICES |
| City | WARREN |
| State | PA |
| Zip Code | 16365 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699771139 | Kamie Dee Repine | Nurse Practitioner | 2 Crescent Park West, Warren Faculty Specialists, Warren, PA 16365-2111 | 2005-06-21 |
| 1528276128 | Jessica S Shepherd | Emergency Medicine | 2 Crescent Park West, Warren Emergency Room, Warren, PA 16365-2111 | 2007-05-18 |
| 1780899567 | Michael Wellington Faulk | Emergency Medicine | 2 Crescent Park West, Warren, PA 16365-2111 | 2007-05-14 |
| 1417092917 | Andrea Leigh Shene | Specialist/Technologist | 2 Crescent Park West, Warren General Hospital, Warren, PA 16365 | 2007-02-21 |
| 1700959103 | Group Medical Services | General Practice | 2 Crescent Park West, Warren, PA 16365-2111 | 2006-11-16 |
| 1396831731 | Melissa Luanne Carter | Emergency Medicine | 2 Crescent Park West, Warren, PA 16365-2111 | 2006-10-05 |
| 1740247956 | John Michael Stoltzfus | Emergency Medicine | 2 Crescent Park West, Warren, PA 16365-2111 | 2006-05-01 |
| 1578552873 | Gregory G Pierson | Emergency Medicine | 2 Crescent Park West, Warren, PA 16365-2111 | 2005-10-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932712759 | James Hickey | Dentist | 94 Egypt Hollow Rd, Warren, PA 16365 | 2020-08-31 |
| 1437674579 | Theresa Elizabeth Cook | Speech-Language Pathologist | Rehabworks At Warren General Hospital, Two Crescent Park West, Warren, PA 16365 | 2017-08-10 |
| 1891160982 | Vanessa Frank Humphrey | Occupational Therapy Assistant | 682 Pleasant Drive, Warren, PA 16365 | 2015-12-01 |
| 1740651967 | John L. Harrington | Psychiatry & Neurology | 4 Second Ave. Apt. #2, Warren, PA 16365 | 2015-10-14 |
| 1992046569 | Carrie Lynn Vaughn | Physical Therapy Assistant | 1048 Pennslvania Ave West, Warren, PA 16365 | 2013-03-07 |
| 1750664488 | William Frederick Menz | Pharmacist | 2901 Market Street, (walmart), Warren, PA 16365 | 2011-09-20 |
| 1669617296 | Donald Nicholas Vandamia | Family Medicine | 64 Leda Lane, Warren, PA 16365 | 2008-12-11 |
| 1013187558 | Chad Michael Ristau | Nurse Anesthetist, Certified Registered | 2 Crescent Park West., Warren General Hospital, Warren, PA 16365 | 2008-03-11 |
| 1407072473 | Family Physical Therapy | Physical Therapist | 218 Liberty St, Warren, PA 16365 | 2007-04-18 |
| 1801927330 | Wal-mart Stores East, L.p. | Technician/Technologist | 2901 Market St., Warren, PA 16365 | 2007-03-08 |
| Find all providers in zip 16365 | ||||
| Taxonomy Code | 133V00000X |
| Grouping | Dietary & Nutritional Service Providers |
| Classification | Dietitian, Registered |
| A registered dietician (RD) is a food and nutrition expert who has successfully completed a minimum of a bachelor’s degree at a US regionally accredited university or college and course work approved by The American Dietetic Association (ADA); an ADA-accredited or approved, supervised practice program, typically 6 to 12 months in length; a national examination administered by the Commission on Dietetic Registration; and continuing professional educational requirements to maintain registration. |
| Notes: Source: The American Dietetic Association. Becoming a Registered Dietitian – a food and nutrition expert. Chicago, IL: The American Dietetic Association, July 1997. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154937753 | Colleen Wojdyla | Dietitian, Registered | 31424 Iroquois Dr, Warren, MI 48088-7009 | 2020-09-18 |
| 1437701240 | Sara M. Szatkowski | Dietitian, Registered | 3849 Dora Dr, Warren, MI 48091-6106 | 2019-07-11 |
| 1477111003 | Elle Marie Bernardo | Dietitian, Registered | 31 Saw Mill Rd, Warren, NJ 07059-5103 | 2019-05-29 |
| 1205369592 | Leigh Marchio | Dietitian, Registered | 1523 Den Jean Dr Ne, Warren, OH 44483-4313 | 2017-04-04 |
| 1447495809 | Denise Stys Marecki | Dietitian, Registered | 30061 Schoenherr Rd., Suite C, Warren, MI 48088 | 2008-12-12 |
| 1659567592 | Grace Derocha | Dietitian, Registered | 30158 Trailwood Dr, Warren, MI 48092-6304 | 2007-09-24 |
| 1902961659 | Lori Kolodin | Dietitian, Registered | 6 Schindelar Woods Way, Warren, NJ 07059-6851 | 2006-12-23 |
| 1205998622 | Andrea Berez | Dietitian, Registered | 17 Cambridge Dr, Warren, NJ 07059-6940 | 2006-12-14 |
| 1396794848 | Nancy Ann Lambert | Dietitian, Registered | 667 Eastland Avenue S.e., Warren, OH 44484 | 2006-05-10 |
| 1194340893 | Shannon Cairns | Dietitian, Registered | 1460 Tod Ave Nw, Warren, OH 44485-2407 | 2020-06-09 |
| Find all providers in WARREN | ||||
Please comment or provide details below to improve the information on MRS. NICOLE MARIE 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.