KATHERINE T CLARK (NPI# 1770146243) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1770146243 |
| Entity Type | Individual |
| Full Name | KATHERINE T CLARK |
| Credential | PHARMD |
| Practice Address |
60101 Bodnar Blvd Ste 100 Mishawaka IN 46544-9328 |
| Mailing Address |
611 E Douglas Rd Ste 406 Mishawaka IN 46545-1468 |
| Practice Telephone | 5743358500 |
| Mailing Telephone | 5743357074 |
| Enumeration Date | 2019-04-19 |
| Last Update Date | 2019-04-19 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 183500000X | Pharmacist | 26027104A | IN | Pharmacy Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992345961 | Katherine Elizabeth Clark | Licensed Practical Nurse | 764 Patriot Pkwy Apt 203, Rock Hill, SC 29730-2750 | 2020-01-08 |
| 1265908818 | Katherine Somers Clark | Dietitian, Registered | 2615 E 20th St, Joplin, MO 64804-1039 | 2018-10-22 |
| 1104364231 | Katherine Mary Clark | Nurse Anesthetist, Certified Registered | 9205 122nd Ct Ne, Apt A107, Kirkland, WA 98033-5882 | 2017-02-09 |
| 1528207131 | Katherine Clark | Physical Therapist | 1630 Campus Park Dr Ste D, Monroe, NC 28112-5270 | 2009-02-05 |
| 1275791949 | Katherine Diane Clark | Counselor | 400 W Midland Ave, Suite 202, Woodland Park, CO 80863-3144 | 2008-05-29 |
| 1194749978 | Katherine Elizabeth Clark | Dentist | 130 Ben Casey Dr, Suite 105, Fort Mill, SC 29708-6567 | 2006-07-26 |
| 1144289943 | Katherine W Clark | Family Medicine | 1 Paradies Ln, New Paltz, NY 12561-4031 | 2006-03-21 |
| 1548229404 | Katherine Ann Clark | Licensed Practical Nurse | 89 Laundon St, Elyria, OH 44035-6117 | 2006-03-20 |
| 1851918783 | Katherine Clark | Student in an Organized Health Care Education/Training Program | 705 Riley Hospital Dr, Indianapolis, IN 46202-5109 | 2020-06-26 |
| 1285254672 | Katherine Audrey Clark | Counselor | 425 S Orleans Ave, Tampa, FL 33606-2139 | 2020-04-26 |
| Street Address |
60101 BODNAR BLVD STE 100 |
| City | MISHAWAKA |
| State | IN |
| Zip Code | 46544-9328 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720692676 | Lynnette Markowicz | Occupational Therapist | 1540 S. Logan St, Mishawaka, IN 46544 | 2020-09-08 |
| 1902429822 | Hellenic Senior Living of Mishawaka LLC | Assisted Living Facility | 1540 S. Logan Street, Mishawaka, IN 46544 | 2020-05-27 |
| 1184275422 | Lorrajean A Gleva | Technician | 203 Eastgate Circle, Mishawaka, IN 46544 | 2019-09-27 |
| 1376072785 | Aims, LLC | Psychologist | 1113 Mossy Lane, Mishawaka, IN 46544 | 2017-06-08 |
| 1760835912 | Ophelia Ansari | Nurse Practitioner | 4501 Linconway East, Mishawaka, IN 46544 | 2016-07-22 |
| 1598153355 | Hearing Aid Service | Hearing Instrument Specialist | 3718 Lincolnway E, Mishawaka, IN 46544 | 2015-01-02 |
| 1437587953 | Christopher Ryan Hazel | Dentist | 544 Lincolnway West, Mishawaka, IN 46544 | 2013-10-18 |
| 1699015941 | Frank Walerko | Urology | 809 Bittersweet Cove Drive, Mishawaka, IN 46544 | 2013-02-25 |
| 1023251337 | Josephine Schimizzi | Family Medicine | 1505 South Spring Street, Mishawaka, IN 46544 | 2009-04-16 |
| 1881831147 | Walgreen Co | Pharmacy | 4620 Lincolnway E, Mishawaka, IN 46544 | 2009-01-08 |
| Find all providers in zip 46544 | ||||
| Taxonomy Code | 183500000X |
| Grouping | Pharmacy Service Providers |
| Classification | Pharmacist |
| An individual licensed by the appropriate state regulatory agency to engage in the practice of pharmacy. The practice of pharmacy includes, but is not limited to, assessment, interpretation, evaluation, and implementation, initiation, monitoring or modification of medication and or medical orders; the compounding or dispensing of medication and or medical orders; participation in drug and device procurement, storage, and selection; drug administration; drug regimen reviews; drug or drug-related research; provision of patient education and the provision of those acts or services necessary to provide medication therapy management services in all areas of patient care. |
| Notes: Source: Adapted from National Association of Boards of Pharmacy Model State Pharmacy Act, Article 1, Section 104. [1/1/2006: definition modified, source modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558997809 | April Hana Park | Pharmacist | 5917 Shawnee Ct Apt 1a, Mishawaka, IN 46545-0926 | 2020-03-19 |
| 1740816354 | Yassmeen Marzuq | Pharmacist | 611 E Douglas Rd Ste 412, Mishawaka, IN 46545-1468 | 2020-03-14 |
| 1104360957 | Josephine Adutwumwaa | Pharmacist | 4105 Parkwood Cir Apt 3b, Mishawaka, IN 46545-2658 | 2016-12-13 |
| 1265824460 | Mekdes Kebede | Pharmacist | 503 E 14th St, Mishawaka, IN 46544-5527 | 2015-02-24 |
| 1548694086 | Mayo Ho Lee | Pharmacist | 420 W Mckinley Ave, Mishawaka, IN 46545-5522 | 2013-08-31 |
| 1609208420 | Katie Lynn Vanbuskirk | Pharmacist | 3425 Bremen Hwy, Mishawaka, IN 46544-6511 | 2013-08-02 |
| 1033710389 | Stephanie H Mahler | Pharmacist | 316 Indian Ridge Blvd, Mishawaka, IN 46545-9034 | 2020-11-03 |
| 1326648932 | Kay Lynn Wood | Pharmacist | 316 Indian Ridge Blvd, Mishawaka, IN 46545-9034 | 2020-11-01 |
| 1891395042 | Victoria Kumfer | Pharmacist | 316 Indian Ridge Blvd, Mishawaka, IN 46545-9034 | 2020-10-27 |
| 1760093272 | Lauren Marie Johnson | Pharmacist | 420 W 4th St Ste 100, Mishawaka, IN 46544-1948 | 2020-08-10 |
| Find all providers in MISHAWAKA | ||||
Please comment or provide details below to improve the information on KATHERINE T 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.