JESSICA C CLARK (NPI# 1760608418) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1760608418 |
| Entity Type | Individual |
| Full Name | JESSICA C CLARK |
| Credential | PA-C |
| Practice Address |
2905 Crouse Ln Burlington NC 27215-8833 |
| Practice Telephone | 3365382494 |
| Practice Fax Number | 3365382497 |
| Mailing Telephone | 3365382494 |
| Mailing Fax Number | 3365382497 |
| Enumeration Date | 2007-04-18 |
| Last Update Date | 2010-03-04 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
MA052894 | PA | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528690906 | Jessica Clark | Doula | 343 N Main Ave, Gresham, OR 97030-7246 | 2020-02-04 |
| 1962054387 | Jessica Lynn Clark | Nurse Practitioner | 7219 N Litchfield Rd Bldg 11302nd, Luke Air Force Base, AZ 85309-1529 | 2019-07-16 |
| 1568962306 | Jessica Lee Clark | Registered Nurse | 6011 Cielo Rnch, San Antonio, TX 78218-4161 | 2018-02-19 |
| 1811416076 | Jessica Clark | Counselor | 42189 Shadow Creek Ave, Gonzales, LA 70737-7241 | 2017-09-19 |
| 1124572821 | Jessica Clark | Specialist | 5664 Cahuenga Blvd, North Hollywood, CA 91601-2103 | 2016-08-10 |
| 1104286871 | Jessica Clark | Counselor | 2575 Westgate Bldg 2, Pendleton, OR 97801-9613 | 2016-02-24 |
| 1942612296 | Jessica Clark | Case Management | 620 John Austin Ln, Mt Washington, KY 40047-6354 | 2014-05-21 |
| 1154610269 | Jessica Clark | Social Worker | 55 Floyd Ave, Riverside, RI 02915-2927 | 2011-03-30 |
| 1346558780 | Jessica Clark | Dietitian, Registered | 187-191 Main Street, Ste 300, Emmaus, PA 18049-4017 | 2010-09-20 |
| 1760794309 | Jessica Michelle Clark | Dentist | 1300 Kempsville Rd Ste 5, Virginia Beach, VA 23464-6199 | 2010-07-12 |
| Street Address |
2905 CROUSE LN |
| City | BURLINGTON |
| State | NC |
| Zip Code | 27215-8833 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740276146 | Neelam Salahuddin Khan | Internal Medicine | 2905 Crouse Ln, Burlington, NC 27215-8833 | 2005-09-21 |
| 1689235806 | Amanda Marie Shirley | Nurse Practitioner | 2905 Crouse Ln, Burlington, NC 27215-8833 | 2019-06-27 |
| 1073000386 | Laboratory Corporation of America Holdings | Clinical Medical Laboratory | 2905 Crouse Ln, Burlington, NC 27215-8833 | 2018-04-23 |
| 1942749155 | Kristin Cunningham | Registered Nurse | 2905 Crouse Ln, Burlington, NC 27215-8833 | 2017-02-21 |
| 1699226142 | Janine Hammond | Nurse Practitioner | 2905 Crouse Ln, Burlington, NC 27215-8833 | 2016-10-19 |
| 1841561974 | Chelsa Boswell | Nurse Practitioner | 2905 Crouse Ln, Burlington, NC 27215-8833 | 2012-01-20 |
| 1376789248 | Pioneer Ambulatory Surgery Center, LLC | Clinic/Center | 2905 Crouse Ln, Burlington, NC 27215-8833 | 2008-12-26 |
| 1346237617 | Sheikh Ahmed Tejan-sie | Internal Medicine | 2905 Crouse Ln, Burlington, NC 27215-8833 | 2005-10-03 |
| 1477549871 | Shaukat Ali Khan | Internal Medicine | 2905 Crouse Ln, Burlington, NC 27215-8833 | 2005-09-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235748708 | Svetlana Nepocatych | Dietitian, Registered | 542 Spaulding St, Burlington, NC 27215 | 2020-07-30 |
| 1992341382 | Gracepoint Recovery Services | Counselor | The Gregory Business Center, 154 Huffman Mill Roal, Burlington, NC 27215 | 2019-11-21 |
| 1336797331 | Kelly Elizabeth Fleming | Preventive Medicine | Stallings-evans Sports Medicine Center, 91 Stadium Drive, Chapel Hill, NC 27215 | 2019-09-03 |
| 1861911968 | Michael Frey | Pharmacist | 2344 South Church St, Burlington, NC 27215 | 2017-09-11 |
| 1174043822 | Comfort Medical Supply LLC | Durable Medical Equipment & Medical Supplies | 1244 Plaza Dr, Burlington, NC 27215 | 2017-06-23 |
| 1811417561 | Burlington Medical Supply LLC | Durable Medical Equipment & Medical Supplies | 1244 Plaza Drive, Burlington, NC 27215 | 2017-06-23 |
| 1912459132 | Herb Mccandless Jr. | Non-emergency Medical Transport (VAN) | 4412 Dogwood Rd, Burlington, NC 27215 | 2016-11-04 |
| 1023479623 | Alpha Diagnostics, LLC | Clinical Medical Laboratory | 3015 South Church St, Burlington, NC 27215 | 2016-03-10 |
| 1669720819 | Lucy Wessinger Menefee | Registered Nurse | Unc Nephrology and Hypertension, 3325 Garden Road, Burlington, NC 27215 | 2012-08-20 |
| 1154685402 | Sheryl Harper | Social Worker | 2815 North Church Street, Burlington, NC 27215 | 2012-07-02 |
| Find all providers in zip 27215 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306299532 | Courtney Simmons Scott | Physician Assistant | 5214 S Nc Highway 62, Burlington, NC 27215-9023 | 2016-07-23 |
| 1821408907 | Laramie Jay Richmond | Physician Assistant | 311 Davis St N, Burlington, ND 58722-2027 | 2014-04-29 |
| 1861668303 | Holly Griffin Hong | Physician Assistant | 1041 Kirkpatrick Rd Ste 100, Burlington, NC 27215-8066 | 2008-05-05 |
| 1407923329 | Martha Parnell Seagrave | Physician Assistant | 425 Pearl Street, Center for Health and Wellbeing, Burlington, VT 05401 | 2006-11-29 |
| 1053406462 | Susan W Fisher | Physician Assistant | 1240 Huffman Mill Road, Attn Emergency Department, Burlington, NC 27511 | 2006-10-03 |
| 1730186024 | Candace Campbell | Physician Assistant | 182 16th St, Burlington, CO 80807-1649 | 2005-07-01 |
| 1568005387 | Mackayla Renee Probasco | Physician Assistant | 911 Sunset Rd, Burlington, NJ 08016-2250 | 2019-10-24 |
| 1285275891 | Amber Blanchard | Physician Assistant | 104 Huffman Mill Rd, Burlington, NC 27215-5113 | 2019-10-04 |
| 1952811564 | Emilie Lise Besl | Physician Assistant | 111 Colchester Ave, Burlington, VT 05401-1473 | 2017-10-09 |
| 1699121244 | Cherie Hendrickson | Physician Assistant | 41 Mall Rd, Burlington, MA 01805-0001 | 2016-05-12 |
| Find all providers in BURLINGTON | ||||
| City | BURLINGTON |
| Zip Code | 27215 |
Please comment or provide details below to improve the information on JESSICA C 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.