STEPHANIE CLARK (NPI# 1881143527) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1881143527 |
| Entity Type | Individual |
| Full Name | STEPHANIE CLARK |
| Practice Address |
2701 17th St Rock Island IL 61201 |
| Mailing Address |
2701 17th St Rock Island IL 61201-5351 |
| Practice Telephone | 3097792031 |
| Mailing Telephone | 3097792031 |
| Enumeration Date | 2016-09-22 |
| Last Update Date | 2018-05-21 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 163WP0808X |
Registered Nurse Specialization: Psych/Mental Health |
041.442753 | IL | Nursing Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922612605 | Stephanie Clark | Massage Therapist | 15227 Spring Cor, San Antonio, TX 78247-1693 | 2020-09-01 |
| 1811516156 | Stephanie Clark | Social Worker | 10185 Isle St, Parker, CO 80134-5788 | 2020-04-15 |
| 1306486444 | Stephanie Clark | Licensed Practical Nurse | 636 Clay Ave Uppr, Rochester, NY 14613-1030 | 2020-01-07 |
| 1841681046 | Stephanie Clark | Technician, Other | 2917 S Ash Ct, Broken Arrow, OK 74012-7804 | 2015-02-09 |
| 1760816326 | Stephanie Diane Clark | Case Manager/Care Coordinator | 4613 Se 41st St, Del City, OK 73115-3703 | 2013-08-30 |
| 1538447560 | Stephanie Renae Clark | Physical Therapist | 927 Battlefield Blvd N, Suite 200, Chesapeake, VA 23320-4853 | 2011-07-25 |
| 1932330545 | Stephanie D Clark | Social Worker | 16581 Us Highway 17 N Ste 600, Hampstead, NC 28443-7451 | 2009-07-30 |
| 1487719787 | Stephanie Clark | Licensed Practical Nurse | 55 Ramble Hill Lane, Millbrook, NY 12545 | 2006-12-27 |
| 1811057425 | Stephanie Clark | Dentist | 7601 A Germantown Ave, Philadelphia, PA 19119 | 2006-12-12 |
| 1700864733 | Stephanie Elaine Clark | Audiologist | 13934 N 59th Ave, Ste 120, Glendale, AZ 85306-4167 | 2006-01-09 |
| Street Address |
2701 17TH ST |
| City | ROCK ISLAND |
| State | IL |
| Zip Code | 61201 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336142629 | Deepak Ahuja | Internal Medicine | 2701 17th St, Rock Island, IL 61201-5351 | 2005-05-31 |
| 1205436052 | Penny Ann Liebbe | Psychiatry & Neurology | 2701 17th St, Rock Island, IL 61201-5351 | 2020-10-30 |
| 1740880863 | Ginger I Busby | Counselor | 2701 17th St, Rock Island, IL 61201-5351 | 2020-10-28 |
| 1366041022 | Elizabeth Erin Montgomery | Registered Nurse | 2701 17th St, Rock Island, IL 61201-5351 | 2020-10-22 |
| 1285232587 | Jillian Elizabeth Spragg | Counselor | 2701 17th St, Rock Island, IL 61201-5393 | 2020-10-09 |
| 1902403140 | Kelsey Jean Mickelson | Counselor | 2701 17th St, Rock Island, IL 61201-5351 | 2020-10-01 |
| 1033725452 | Amber Michelle Winters | Counselor | 2701 17th St, Rock Island, IL 61201-5351 | 2020-09-21 |
| 1295341865 | Kaitlyn Dawn Shannon | Counselor | 2701 17th St, Rock Island, IL 61201-5351 | 2020-09-19 |
| 1902412539 | Alex Strupp | Counselor | 2701 17th St, Rock Island, IL 61201-5351 | 2020-09-18 |
| 1861008641 | Leanne Elizabeth Zazzetti | Counselor | 2701 17th St, Rock Island, IL 61201-5351 | 2020-09-17 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689206245 | Judy Kay Moore | Technician | 2439 8th Ave, Rock Island, IL 61201 | 2020-02-11 |
| 1053956862 | Christina Beam | Counselor | 1413 40th Street, Rock Island, IL 61201 | 2019-11-15 |
| 1356843817 | Stephanie Kaye Jones | Counselor | 2701 17th St., Rock Island, IL 61201 | 2018-03-01 |
| 1073062030 | Innovative Transport Enterprise, LLC | Non-emergency Medical Transport (VAN) | 2239 24th Street Apt 15c, Rock Island, IL 61201 | 2016-09-30 |
| 1124575733 | Robert Young Center | Community Based Residential Treatment Facility, Mental Illness | 2701 - 17 Street, Rockisland, IL 61201 | 2016-09-01 |
| 1538520903 | James Keith Frainey | Psychologist | 805 19th Street, Transitions Mhs, Rock Island, IL 61201 | 2016-03-14 |
| 1417340837 | Brandon Lee Sachwitz | Physician Assistant | 2701 17th Street, Trinity Medical Center, Rock Island, IL 61201 | 2015-03-10 |
| 1215366679 | Kimberly Lyall | Physical Therapy Assistant | 767 30th Street, Rock Island, IL 61201 | 2013-11-06 |
| 1386080745 | The Abbey Center, LLC | Clinic/Center | 3031 5th Ave., Rock Island, IL 61201 | 2013-05-13 |
| 1487097382 | Joe Lee Westerhof | Veterinarian | 2529 11th St, Rock Island, IL 61201 | 2013-04-10 |
| Find all providers in zip 61201 | ||||
| Taxonomy Code | 163WP0808X |
| Grouping | Nursing Service Providers |
| Classification | Registered Nurse |
| Specialization | Psych/Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366041022 | Elizabeth Erin Montgomery | Registered Nurse | 2701 17th St, Rock Island, IL 61201-5351 | 2020-10-22 |
| 1205481512 | Stormie Kay Nichole Barton | Registered Nurse | 2701 17th St, Rock Island, IL 61201-5351 | 2019-08-04 |
| 1174181556 | Jayne Marie Tyrrell | Registered Nurse | 2701 17th St, Rock Island, IL 61201-5351 | 2019-05-31 |
| 1821571894 | Patricia Lynn Hernandez | Registered Nurse | 2701 17th St, Rock Island, IL 61201-5351 | 2018-09-14 |
| 1275029175 | Shannon Faeth | Registered Nurse | 2701 17th St, Rock Island, IL 61201-5351 | 2018-07-03 |
| 1881180842 | Tammy Jane Mccracken | Registered Nurse | 2701 17th St, Rock Island, IL 61201-5351 | 2018-07-02 |
| 1992296503 | Beatrice Ann Minear | Registered Nurse | 2701 17th St, Rock Island, IL 61201-5351 | 2018-05-21 |
| 1710496765 | Taja Hanson | Registered Nurse | 2701 17th St, Rock Island, IL 61201-5351 | 2017-09-21 |
| 1851815112 | Susan E Medinger | Registered Nurse | 2701 17th St, Rock Island, IL 61201-5351 | 2017-07-28 |
| 1407378631 | Crystal Schoen | Registered Nurse | 2701 17th St, Rock Island, IL 61201-5351 | 2017-07-10 |
| Find all providers in ROCK ISLAND | ||||
| City | ROCK ISLAND |
| Zip Code | 61201 |
Please comment or provide details below to improve the information on STEPHANIE 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.