Clear Skin Medical Solutions, LLC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

A001877 Issued in AR

Legal business name

CLEAR SKIN MEDICAL SOLUTIONS, LLC

Practice address

715 W Sherman Ave
Suite H
Harrison, AR 72601-2743

Phone

(870) 204-5346

Fax

(870) 365-0481

NPI assigned

Aug 16, 2014

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Pamela Robin Griffin, APRN

Title

MGR/Member

Phone

(870) 204-5346

Specialties & licenses 1

Addresses

Other identifiers 1

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1408147200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1408147200000",
    "number": "1003215955",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1102",
            "city": "HARRISON",
            "state": "AR",
            "postal_code": "726021102",
            "telephone_number": "870-204-5346",
            "fax_number": "870-365-0481"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "715 W SHERMAN AVE",
            "address_2": "SUITE H",
            "city": "HARRISON",
            "state": "AR",
            "postal_code": "726012743",
            "telephone_number": "870-204-5346",
            "fax_number": "870-365-0481"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLEAR SKIN MEDICAL SOLUTIONS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-08-16",
        "last_updated": "2014-08-16",
        "status": "A",
        "authorized_official_last_name": "GRIFFIN",
        "authorized_official_first_name": "PAMELA",
        "authorized_official_middle_name": "ROBIN",
        "authorized_official_title_or_position": "MGR/MEMBER",
        "authorized_official_telephone_number": "870-204-5346",
        "authorized_official_credential": "APRN"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "AR",
            "license": "A001877",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "190397758",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jodie M Clark, LMT
• Natasha Clark
• Candace Clarke, RN, LM
• Theera Rojanapremsuk Clarke, M.D.
• Cathy J Clary, MD
• James Michael Coats, D.C.
• Terri Lynn Coats, D.C.
• Andrew L. Coble, M.D.
• Michelle Coffman, QBHP
• Joseph Alan Cofrancesco, COTA

• Family Nurse Practitioner in Harrison, AR
• Providers in Harrison, AR by specialty
• Family Nurse Practitioner in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.