MRS. KIMBERLY ANN CLARK RN MSN FNP-C NPI 1508405028

NPI Information

NPI: 1508405028
Provider Name: MRS. KIMBERLY ANN CLARK, RN MSN FNP-C
Classification: Nurse Practitioner - 363LF0000X
Entity Type: Individual

Specialization: Family

PECOS Registration: Yes

Address:
307 EAST 9TH STREET
WHEELER, TX
ZIP 79096
Phone: (580) 558-8543
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MRS. Kimberly Ann Clark, RN MSN FNP-C is a family nurse practitioner in Wheeler, TX with 4 years of experience. MRS. Kimberly Ann Clark, RN MSN FNP-C NPI is 1508405028. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

307 EAST 9TH STREET
WHEELER, TX
ZIP 79096-030
Phone: (580) 558-8543
Fax: (630) 570-6352

The NPI 1508405028 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 12/31/2019 and was last updated on 10/20/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	163WC0400X	Registered Nurse	Case Management	95760	OKLAHOMA	No
2	363LF0000X	Nurse Practitioner	Family	1014028	TEXAS	Yes
3	363LF0000X	Nurse Practitioner	Family	F05200738	OKLAHOMA	No

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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