Jessica Clark-Gomez in Richland Center - Licensed Practical Nurse
Jessica Clark-Gomez - NPI 1275727141
Jessica Clark-Gomez is a Licensed Practical Nurse in Richland Center, Wisconsin. Jessica Clark-Gomez practices all healthcare services and medical treatments related to Licensed Practical Nurse. The NPI Number for Jessica Clark-Gomez is 1275727141. The last update date is 2007-09-04.
Jessica Clark-Gomez's current location address is 342 E Union St, Richland Center, Wisconsin. You can contact this provider via phone number 6086476415. The mailing address for Jessica Clark-Gomez is 342 E Union St, Richland Center, Wisconsin. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Jessica Clark-Gomez |
|---|---|
| Address | 342 E Union St, Richland Center, Wisconsin |
| Phone Number | 6086476415 |
| Fax Number | |
| Sole Proprietor | Y |
| Credentials | -- |
NPI Number Detail
| NPI Number | 1275727141 |
|---|---|
| Provider Enumeration Date | 2007-09-04 |
| Last Updated Date | 2007-09-04 |
Provider Mailing Address Detail
| Address | 342 E Union St |
|---|---|
| City | Richland Center |
| State | Wisconsin (WI) |
| Post Code | 535812217 |
| Phone Number | 6086476415 |
| Fax Number |
Provider's Primary Taxonomy Detail
| Speciality | Licensed Practical Nurse |
|---|---|
| Taxonomy | 164W00000X |
|
Definition: An individual with post-high school vocational training and practical experience in the provision of nursing care at a level less than that required for certification as a Registered Nurse. Requirements for education, experience, licensure, and job r |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 35030800 | WI | -- |
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What is the unique 10-digit identification code issued to Jessica Clark-Gomez by the Centers for Medicare & Medicaid Services?
The Jessica Clark-Gomez has been assigned the NPI (National Provider Identifier) 1275727141 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code serves as a unique identifier for healthcare providers.
Could you please share the complete physical location address where Jessica Clark-Gomez's facilities are situated?
The facilities of Jessica Clark-Gomez are physically located at the following address: 342 E Union St, Richland Center, WI, 535812217.
What is Jessica Clark-Gomez's specialized area of practice, and what is the corresponding taxonomy classification code for this field?
The Jessica Clark-Gomez's specialized field of practice is Licensed Practical Nurse, and the corresponding taxonomy code that categorizes this area of specialization is 164W00000X.
On what date did the Jessica Clark-Gomez receive its 1275727141 assignment from the Centers for Medicare & Medicaid Services?
The Jessica Clark-Gomez was assigned its 1275727141 by the Centers for Medicare & Medicaid Services on 2007-09-04.
As of what date were the Jessica Clark-Gomez's details last updated?
The information pertaining to the Jessica Clark-Gomez, including its address, specialty, and other details, was most recently updated on 2007-09-04.