Luann S Clark, RN

Primary specialty

Registered NurseTaxonomy code 163W00000X

Practice address

Luann Clark 1001 Edgewater Rd
Fort Atkinson, WI 53538-1901

Phone

(920) 568-1203

NPI assigned

Oct 16, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

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

{
    "created_epoch": "1192492800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1192492800000",
    "number": "1013106921",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "LUANN CLARK 1001 EDGEWATER RD",
            "city": "FORT ATKINSON",
            "state": "WI",
            "postal_code": "53538",
            "telephone_number": "920-568-1203"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "LUANN CLARK 1001 EDGEWATER RD",
            "city": "FORT ATKINSON",
            "state": "WI",
            "postal_code": "535381901",
            "telephone_number": "920-568-1203"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "LUANN",
        "middle_name": "S",
        "name_prefix": "Ms.",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-10-16",
        "last_updated": "2007-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "WI",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christine A Chuppa, M.D.
• Jeffrey A Cichocki, CRNA
• Laura K. Cichocki, CRNA
• City of Fort Atkinson
• James A Clark, CADCIII
• Michael Anthony Coletta, RPH
• Colleen a. Mitchell Psychological Services
• Clark A Collins, PA-C
• C. Sue Conley, M.D.
• Patience Marie Cosson, M.S. CCC-SLP

• Registered Nurse in Fort Atkinson, WI
• Providers in Fort Atkinson, WI by specialty
• Registered Nurse in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2007; 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.