MARY ELLEN CLARK (NPI# 1891031621) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1891031621 |
| Entity Type | Individual |
| Full Name | MARY ELLEN CLARK |
| Other Name | MARY ELLEN HEROD |
| Credential | CFNP |
| Practice Address |
201 Cedar St Se Suite 4620 Albuquerque NM 87106-4917 |
| Mailing Address |
Po Box 26666 Albuquerque NM 87125-6666 |
| Practice Telephone | 5055631309 |
| Practice Fax Number | 5052247156 |
| Enumeration Date | 2012-12-26 |
| Last Update Date | 2015-02-18 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
CNP-02460 | NM | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363LF0000X |
Nurse Practitioner Specialization: Family |
201250210NP | OR | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255958252 | Mary Beth Clark | Speech-Language Pathologist | 18 La Salle Ave, Sioux City, IA 51104-2412 | 2020-06-25 |
| 1205461266 | Mary Clark | Nurse's Aide | 229 Elmhurst Rd, Dayton, OH 45417-1420 | 2020-03-10 |
| 1366981839 | Mary Clark | Acupuncturist | 8380 Six Forks Rd Ste 203, Raleigh, NC 27615-5091 | 2017-02-16 |
| 1740698935 | Mary Christine Clark | Lactation Consultant, Non-RN | 2774 230th St, Cushing, WI 54006-3421 | 2014-07-31 |
| 1982022562 | Mary Clark | Non-emergency Medical Transport (VAN) | 2957 Brogdon Rd, Alcolu, SC 29001-8637 | 2014-04-01 |
| 1760825392 | Mary Elizabeth Clark | Doula | 8634 Oakside Ave, Commerce Township, MI 48382-3763 | 2013-04-13 |
| 1336497460 | Mary Clark | Chiropractor | 298 Federal Hill Rd, Milford, NH 03055-3553 | 2012-08-21 |
| 1730460098 | Mary Jo Clark | Specialist | 2691 Highway 62 412, Highland, AR 72542-9479 | 2011-08-31 |
| 1649559410 | Mary Jackson Clark | Counselor | 904 Washington Rd Ste A, Westminster, MD 21157-5838 | 2011-08-11 |
| 1952691461 | Mary Denise Clark | Doula | 1070 Milo Cir Apt B, Lafayette, CO 80026-3089 | 2011-04-18 |
| Street Address |
201 CEDAR ST SE SUITE 4620 |
| City | ALBUQUERQUE |
| State | NM |
| Zip Code | 87106-4917 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053315390 | Robert E. Federici | Internal Medicine | 201 Cedar St Se, Suite 7600, Albuquerque, NM 87106-4917 | 2005-06-01 |
| 1184269581 | Felicia Strange | Physician Assistant | 201 Cedar St Se, Albuquerque, NM 87106-4917 | 2019-11-10 |
| 1033699731 | Jessica Frances Brisson | Physician Assistant | 201 Cedar St Se, Albuquerque, NM 87106-4917 | 2018-08-21 |
| 1043759756 | Diana Lynn Gabaldon | Pharmacist | 201 Cedar St Se, Suite 4620, Albuquerque, NM 87106-4917 | 2017-02-14 |
| 1891233045 | Presbyterian Healthcare Services | General Acute Care Hospital | 201 Cedar St Se, Suite 4602, Albuquerque, NM 87106-4917 | 2017-02-08 |
| 1366993024 | Anne Karlovitz | Nurse Practitioner | 201 Cedar St Se, Albuquerque, NM 87106-4917 | 2016-10-18 |
| 1346691649 | Cara J Garner | Dietitian, Registered | 201 Cedar St Se, Suite 4660, Albuquerque, NM 87106-4917 | 2016-06-28 |
| 1922479914 | Michelle Maxedon | Genetic Counselor, MS | 201 Cedar St Se, Suite 405, Albuquerque, NM 87106-4917 | 2015-10-15 |
| 1366827537 | Sarah Streng | Occupational Therapist | 201 Cedar St Se, Suite 6600, Albuquerque, NM 87106-4917 | 2015-07-29 |
| 1306228283 | Cristina Ferraro | Physician Assistant | 201 Cedar St Se, Suite 7600, Albuquerque, NM 87106-4917 | 2015-06-26 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629679808 | Jorge Licano | Student in an Organized Health Care Education/Training Program | Unmh Hospital 2211 Lomas Blvd Ne, Albuquerque, NM 87106 | 2020-11-04 |
| 1730780032 | Joseph Sanchez | Student in an Organized Health Care Education/Training Program | (unmh Hospital 2211 Lomas Blvd Ne, Albuquerque, NM 87106 | 2020-11-03 |
| 1336746205 | Evan Laub | Pharmacist | 2950 Central Ave. Sw, Albuquerque, NM 87106 | 2020-10-05 |
| 1487203154 | Theresa Martinez | Technician | 5680 Avedon Dr. Se, Albuquerque, NM 87106 | 2019-09-05 |
| 1205300647 | Louis Mayer II | Specialist/Technologist | 1414 University Blvd Tow Diehm Athletic Facility, Albuquerque, NM 87106 | 2019-01-18 |
| 1235633355 | Terrena Grace Vigil Brady | Occupational Therapist | 1001 Yale Blvd, Albuquerque, NM 87106 | 2018-03-22 |
| 1205355195 | Yaritza Ruiz | Specialist/Technologist | 1200 Avenida Cesar Chavez, 231d, Albuquerque, NM 87106 | 2017-09-12 |
| 1457873382 | Cynthia Bluhm | Registered Nurse | 7600 Cedar St Se Ste 7600, Albuquerque, NM 87106 | 2017-07-12 |
| 1295265882 | Hallie Chancellor | Behavior Technician | 1801 Gibson Blvd Se Apt 1046, Albuquerque, NM 87106 | 2017-06-15 |
| 1780111757 | Jiana Hook | Physical Medicine & Rehabilitation | 1414 University Blvd. Se, Albuquerque, NM 87106 | 2017-05-22 |
| Find all providers in zip 87106 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497354328 | Tracy Bui | Nurse Practitioner | 9200 Timber Ridge Rd Nw, Albuquerque, NM 87120-6278 | 2020-10-21 |
| 1558969253 | Beverly Carter | Nurse Practitioner | 5021 Nelson Pl Nw, Albuquerque, NM 87114-4320 | 2020-10-14 |
| 1932706223 | Rozita Dayani | Nurse Practitioner | 6821 Promenade Ave Ne, Albuquerque, NM 87109-2824 | 2020-10-08 |
| 1730795626 | Jia Wu | Nurse Practitioner | 7124 Marseille Pl Ne, Albuquerque, NM 87122-3328 | 2020-09-17 |
| 1912513870 | Ariel A Nunez | Nurse Practitioner | 500 Walter Street Ne, Suite 216, Lovelace Medical Towers - Clinical Informatics, Albuquerque, NM 87102-2543 | 2020-09-16 |
| 1326652173 | Matthew S Fogel | Nurse Practitioner | 3129 Casa Bonita Dr Ne, Albuquerque, NM 87111-5607 | 2020-08-31 |
| 1467065532 | Amberleigh Morrish | Nurse Practitioner | 2100 George Rd Se # 19012, Albuquerque, NM 87106-5608 | 2020-08-28 |
| 1457962102 | Roxanne Christian | Nurse Practitioner | 1909 Brookhaven Pl Nw, Albuquerque, NM 87120-8006 | 2020-08-14 |
| 1689298879 | Marissa Jenee Simpson | Nurse Practitioner | 4839 Stafford Pl Nw, Albuquerque, NM 87120-3232 | 2020-06-03 |
| 1306465810 | Alice Xiao Arellano | Nurse Practitioner | 13512 Red Yucca Ave Ne, Albuquerque, NM 87111-8226 | 2020-04-14 |
| Find all providers in ALBUQUERQUE | ||||
| City | ALBUQUERQUE |
| Zip Code | 87106 |
Please comment or provide details below to improve the information on MARY ELLEN 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.