MS. ABIGAIL MAE CLARK (NPI# 1740528611) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1740528611 |
| Entity Type | Individual |
| Full Name | MS. ABIGAIL MAE CLARK |
| Credential | PA-C |
| Practice Address |
2090 Woodwinds Dr Woodbury MN 55125-2522 |
| Mailing Address |
710 Commerce Dr Ste 200 Woodbury MN 55125-4925 |
| Practice Telephone | 6519685801 |
| Practice Fax Number | 6519685899 |
| Mailing Telephone | 6519685042 |
| Mailing Fax Number | 6519685904 |
| Enumeration Date | 2013-01-28 |
| Last Update Date | 2019-08-30 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
11698 | MN | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720607633 | Abigail Clark | Student in an Organized Health Care Education/Training Program | 800 Rose St Ste C-246, Lexington, KY 40536-0293 | 2020-04-10 |
| 1427659705 | Abigail Louise Clark | Pharmacist | 3551 N Ridge East, Ashtabula, OH 44004-4313 | 2020-11-04 |
| 1962014035 | Abigail Clark | Licensed Practical Nurse | 4455 E 12th Ave, Denver, CO 80220-2415 | 2020-08-20 |
| 1902442411 | Abigail Clark | Speech-Language Pathologist | 800 E Carpenter St, Springfield, IL 62769-1000 | 2019-11-19 |
| 1013481472 | Abigail Clark | Developmental Therapist | 345 Greenwood St Ste A, Worcester, MA 01607-1767 | 2019-01-17 |
| 1033616032 | Abigail Clark | Psychiatry & Neurology | 9500 Gilman Dr # 9116a, La Jolla, CA 92093 | 2018-04-07 |
| 1871006668 | Abigail M Clark | Community Health Worker | 838 Coburn St, Akron, OH 44311-1459 | 2017-11-15 |
| 1932267473 | Abigail Clark | Social Worker | 2707 Browns Ln, Jonesboro, AR 72401-7213 | 2006-12-05 |
| Street Address |
2090 WOODWINDS DR |
| City | WOODBURY |
| State | MN |
| Zip Code | 55125-2522 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538137732 | Amy Stromwall Beacom | Emergency Medicine | 2090 Woodwinds Dr, Woodbury, MN 55125-2522 | 2006-03-14 |
| 1659928703 | Austin Moore | Physical Therapist | 2090 Woodwinds Dr, Woodbury, MN 55125-2522 | 2019-08-23 |
| 1962965848 | Molly Michelle Mullee | Physician Assistant | 2090 Woodwinds Dr, Woodbury, MN 55125-2522 | 2019-04-09 |
| 1306312814 | Sarah Renee Wittak | Occupational Therapist | 2090 Woodwinds Dr, Woodbury, MN 55125-2522 | 2018-10-23 |
| 1124517677 | Joshua Allan Albarado | Occupational Therapist | 2090 Woodwinds Dr, Woodbury, MN 55125-2522 | 2018-05-09 |
| 1013458009 | Abby Mohr | Physician Assistant | 2090 Woodwinds Dr, Woodbury, MN 55125-2522 | 2017-03-10 |
| 1366898371 | William Thompson | Physician Assistant | 2090 Woodwinds Dr, Woodbury, MN 55125-2522 | 2016-05-09 |
| 1598125817 | Nathan L Reimnitz | Physician Assistant | 2090 Woodwinds Dr, Woodbury, MN 55125-2522 | 2016-02-29 |
| 1861851172 | Anthony J Sterk | Physician Assistant | 2090 Woodwinds Dr, Woodbury, MN 55125-2522 | 2016-02-15 |
| 1386025187 | Alex Villano | Physician Assistant | 2090 Woodwinds Dr, Woodbury, MN 55125-2522 | 2015-06-17 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487268728 | Haley Kirkpatrick | Behavior Technician | 721 Commerce Dr., Woodbury, MN 55125 | 2020-09-03 |
| 1689218091 | Jordan Schmidt | Student in an Organized Health Care Education/Training Program | 1740 Welr Dr. #24, Woodbury, MN 55125 | 2019-10-30 |
| 1629619580 | Mackenzie Ann Funke | Occupational Therapist | 721 Commerce Drivve, Woodbury, MN 55125 | 2019-10-02 |
| 1700342029 | Darcy Stivland | Counselor | 1811 Weir Drive #270, Woodbury, MN 55125 | 2019-02-11 |
| 1235609884 | Elizabeth Kennedy Ward | Psychologist | 7582 Currell Blvd Suite 208, Woodbury, MN 55125 | 2018-11-27 |
| 1528573664 | Cory Lee Baumeister | Counselor | 652 Bielenberg Dr, Woodbury, MN 55125 | 2017-12-12 |
| 1760918239 | David James Knight | Dentist | 9950 Valley Creek Rd Ste 150, Woodbury, MN 55125 | 2017-05-03 |
| 1366988826 | Mark Your Home Health Care LLC | Home Health | 6053 Hudson Road, Suite 200, Woodbury, MN 55125 | 2017-01-09 |
| 1518415736 | Kubei Holdings Group LLC | Case Management | 6043 Hudson Rd Ste 340, Saint Paul, MN 55125 | 2016-09-16 |
| 1285087072 | Adrian Jung | Occupational Therapist | 155 Radio Drive, Woodbury, MN 55125 | 2016-07-18 |
| Find all providers in zip 55125 | ||||
| Taxonomy Code | 363AS0400X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Surgical Technologist |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902041536 | James D Fulginiti | Physician Assistant | 603 North Broad Steet, Craig H. Rosen, M.d.,p.a., Woodbury, NJ 08096 | 2008-12-11 |
| 1043270952 | David Preston Law | Physician Assistant | 2090 Woodwinds Dr Ste 200, Woodbury, MN 55125-2522 | 2006-03-24 |
| 1720057334 | Mary C Aschenbrener | Physician Assistant | 215 Radio Dr Ste 100, Woodbury, MN 55125-5817 | 2006-03-16 |
| 1063057628 | Margaret Faust | Physician Assistant | 2090 Woodwinds Dr Ste 200, Woodbury, MN 55125-2522 | 2019-11-07 |
| 1306404835 | Madison Lee Haus | Physician Assistant | 2090 Woodwinds Dr Ste 200, Woodbury, MN 55125-2522 | 2019-05-30 |
| 1740844794 | Maren Fiscus | Physician Assistant | 2090 Woodwinds Dr Ste 200, Woodbury, MN 55125-2522 | 2019-04-25 |
| 1962965848 | Molly Michelle Mullee | Physician Assistant | 2090 Woodwinds Dr, Woodbury, MN 55125-2522 | 2019-04-09 |
| 1013458009 | Abby Mohr | Physician Assistant | 2090 Woodwinds Dr, Woodbury, MN 55125-2522 | 2017-03-10 |
| 1497135172 | Natasha Harr | Physician Assistant | 2090 Woodwinds Dr, Woodbury, MN 55125-2522 | 2015-06-08 |
| 1851795827 | Megan Anne Heck | Physician Assistant | 2090 Woodwinds Dr, Woodbury, MN 55125-4925 | 2014-10-20 |
| Find all providers in WOODBURY | ||||
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| 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.