Kathleen Marie Clark in Long Beach - Nurse Practitioner
Kathleen Marie Clark - NPI 1083774582
Kathleen Marie Clark is a Nurse Practitioner in Long Beach, California. Kathleen Marie Clark practices all healthcare services and medical treatments related to Nurse Practitioner. The NPI Number for Kathleen Marie Clark is 1083774582. The last update date is 2007-07-08.
Kathleen Marie Clark's current location address is 1250 Bellflower Blvd, Long Beach, California. You can contact this provider via phone number 5629855146 and fax number 5629858404. The mailing address for Kathleen Marie Clark is 1250 Bellflower Blvd, Long Beach, California. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Kathleen Marie Clark |
|---|---|
| Address | 1250 Bellflower Blvd, Long Beach, California |
| Phone Number | 5629855146 |
| Fax Number | 5629858404 |
| Sole Proprietor | N |
| Credentials | MSN FNP C |
NPI Number Detail
| NPI Number | 1083774582 |
|---|---|
| Provider Enumeration Date | 2006-12-12 |
| Last Updated Date | 2007-07-08 |
Provider Mailing Address Detail
| Address | 1250 Bellflower Blvd |
|---|---|
| City | Long Beach |
| State | California (CA) |
| Post Code | 908400201 |
| Phone Number | 5629855146 |
| Fax Number | 5629858404 |
Provider's Primary Taxonomy Detail
| Speciality | Nurse Practitioner |
|---|---|
| Taxonomy | 363L00000X |
| Licence No | 16395 |
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Definition: (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certifi |
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What is the unique identifier code issued to Kathleen Marie Clark by the Centers for Medicare & Medicaid Services (CMS)?
The Kathleen Marie Clark has been assigned the NPI (National Provider Identifier) 1083774582. This 10-digit code serves as a unique identification number for healthcare providers, issued by the CMS.
Could you please provide the complete physical location address of Kathleen Marie Clark?
The Kathleen Marie Clark is physically situated at 1250 Bellflower Blvd, in the city of Long Beach, state of CA, with the postal code 908400201.
What is the Kathleen Marie Clark's area of specialization and corresponding taxonomy classification?
The Kathleen Marie Clark's specialty field is Nurse Practitioner, and it falls under the taxonomy code 363L00000X, which categorizes healthcare providers based on their specialties.
On what date did the Kathleen Marie Clark receive the assignment of its 1083774582 from the Centers for Medicare & Medicaid Services?
The Kathleen Marie Clark was issued its 1083774582 by the Centers for Medicare & Medicaid Services on 2006-12-12.
As of what date were the details related to Kathleen Marie Clark most recently updated or revised?
The information pertaining to Kathleen Marie Clark, including its address, specialty, and other relevant details, was last updated or revised on 2007-07-08.