B. CAROL CLARK-KUTSCHER (NPI# 1962507087) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1962507087 |
| Entity Type | Individual |
| Full Name | B. CAROL CLARK-KUTSCHER |
| Credential | ANP |
| Practice Address |
409 W Oak St Carbondale IL 62901-1414 |
| Mailing Address |
Po Box 1105 Indianapolis IN 46206-1105 |
| Practice Telephone | 6185294455 |
| Practice Fax Number | 6183511287 |
| Mailing Telephone | 6185294455 |
| Mailing Fax Number | 6183511287 |
| Enumeration Date | 2006-09-13 |
| Last Update Date | 2012-02-16 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LA2200X |
Nurse Practitioner Specialization: Adult Health |
209007469 | IL | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363LA2200X |
Nurse Practitioner Specialization: Adult Health |
114921 | MO | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MO | 428317200 | 05 |
| Street Address |
409 W OAK ST |
| City | CARBONDALE |
| State | IL |
| Zip Code | 62901-1414 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366445975 | Agnes Blanche Delaney | Physician Assistant | 409 W Oak St, Carbondale, IL 62901-1464 | 2005-05-27 |
| 1003466269 | Lukas Ward | Physician Assistant | 409 W Oak St, Carbondale, IL 62901-1464 | 2019-09-18 |
| 1720632508 | Kaitlin Elizabeth Behnken | Internal Medicine | 409 W Oak St, Carbondale, IL 62901-1464 | 2019-07-30 |
| 1356995401 | Cassandra Chambers | Internal Medicine | 409 W Oak St, Carbondale, IL 62901-1464 | 2019-07-27 |
| 1992280598 | Corrie Lynn Farris | Physician Assistant | 409 W Oak St, Carbondale, IL 62901-1464 | 2018-09-28 |
| 1497255947 | Kimberly Hankins | Internal Medicine | 409 W Oak St, Carbondale, IL 62901-1464 | 2018-02-20 |
| 1689029993 | Ashley L. Brown | Internal Medicine | 409 W Oak St, Carbondale, IL 62901-1464 | 2016-04-25 |
| 1669833026 | Jessica Milburn | Nurse Practitioner | 409 W Oak St, Carbondale, IL 62901-1464 | 2016-03-14 |
| 1093193773 | Andrea Williams | Internal Medicine | 409 W Oak St, Carbondale, IL 62901-1414 | 2015-05-13 |
| 1730578535 | Desiree Castonguay | Physician Assistant | 409 W Oak St, 202, Carbondale, IL 62901-1414 | 2015-01-16 |
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|---|---|---|---|---|
| 1558961268 | Gerad Aaron Harsy | Pharmacist | Walmart Pharmcy, 1450 East Main St, Carbondale, IL 62901 | 2020-10-30 |
| 1437708674 | Board of Trustees of Southern Illinois University | Clinic/Center | 300 W Oak Street, Carbondale, IL 62901 | 2019-09-10 |
| 1306317383 | Rachael O Johnson | Nurse Practitioner | 404 S. Lewis Ln, Carbondale, IL 62901 | 2018-12-17 |
| 1740795194 | Megan Marie Zimmerman | Nurse Practitioner | 1100 W Diann Ln., Carbondale, IL 62901 | 2017-12-07 |
| 1295244242 | Amy Elizabeth Prudencio | Social Worker | 1301 E. Walnut Street, Carbondale, IL 62901 | 2017-09-21 |
| 1740708171 | Theresa Aleise Goodin | Speech-Language Pathologist | 1301 East Walnut Street, Carbondale, IL 62901 | 2017-09-06 |
| 1144762527 | Kathleen Chwalisz Rigney | Psychologist | 306 West Mill Street, Neurorestorative, Carbondale, IL 62901 | 2016-11-16 |
| 1285185173 | Shawnee Health Service and Development Corp | Social Worker | 404 S. Lewis Lane, Carbondale, IL 62901 | 2016-10-17 |
| 1437605094 | Arielle Greer | Nurse's Aide | 510 E. Russell St., A, Carbondale, IL 62901 | 2016-09-01 |
| 1518413863 | Complete Family Eyecare of Carbondale, PC | Optometrist | 1241 East Walnut Street, Carbondale, IL 62901 | 2016-08-28 |
| Find all providers in zip 62901 | ||||
| Taxonomy Code | 363LA2200X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Adult Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356649313 | Amy Marie Surburg | Nurse Practitioner | 405 W Jackson, Pre-anesthesia Department, Carbondale, IL 62901-9000 | 2011-03-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851998553 | Melissa Litwin | Nurse Practitioner | 9127 Burlington Ave, Brookfield, IL 60513-1939 | 2020-10-06 |
| 1932724200 | Tatyana Menaker | Nurse Practitioner | 2958 West Devon Ave, Chicago, IL 60659 | 2020-06-12 |
| 1518506625 | Lila Macalinga Rivera | Nurse Practitioner | 17w335 16th St, Oakbrook Terrace, IL 60181-4030 | 2020-01-06 |
| 1922642495 | Christine Nacar | Nurse Practitioner | 1232 Le Moyne Ave, Romeoville, IL 60446-4180 | 2019-10-29 |
| 1144871344 | Wensheng Tracy Wu | Nurse Practitioner | 1555 Barrington Rd Ste 1200, Hoffman Estates, IL 60169-5036 | 2019-09-27 |
| 1881245314 | Mkbb LLC | Nurse Practitioner | 1212 E Algonquin Rd, Algonquin, IL 60102-5446 | 2019-09-25 |
| 1225681455 | Jinu Joss | Nurse Practitioner | 9939 N Warren Oval, Niles, IL 60714-1044 | 2019-07-17 |
| 1659830057 | Ginger Dean | Nurse Practitioner | 2843 Chicago Rd, South Chicago Heights, IL 60411-4736 | 2019-03-15 |
| 1770048910 | Amanda K Honchell I | Nurse Practitioner | 401 W Madison St, Mount Carroll, IL 61053-9485 | 2019-02-01 |
| 1548725799 | Grace Nwaka Wabomnor | Nurse Practitioner | 17 E Grandview Dr, South Holland, IL 60473-1099 | 2019-02-01 |
| Find all providers with the same taxonomy | ||||
| City | CARBONDALE |
| Zip Code | 62901 |
Please comment or provide details below to improve the information on B. CAROL CLARK-KUTSCHER.
| 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.