Lorena K. C. Clark, ARNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

F08210430 Issued in FL

Practice address

12210 Creek Preserve Dr
Riverview, FL 33579-6501

Phone

(646) 256-3988

NPI assigned

Oct 12, 2021

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1633996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633996800000",
    "number": "1114689650",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12210 CREEK PRESERVE DR",
            "city": "RIVERVIEW",
            "state": "FL",
            "postal_code": "335796501",
            "telephone_number": "646-256-3988"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12210 CREEK PRESERVE DR",
            "city": "RIVERVIEW",
            "state": "FL",
            "postal_code": "335796501",
            "telephone_number": "646-256-3988"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "LORENA",
        "middle_name": "K. C.",
        "credential": "ARNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-10-12",
        "last_updated": "2021-10-12",
        "certification_date": "2021-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "RN9479417",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "F08210430",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kirbee Cirasuolo
• Alaysha Clark
• Crystal Nache Clark, LMHC
• Deanna Lynn Clark
• Kaylin Clark
• Yvonne Joan Clarke, ARNP
• Carol Ann Clarkson, LDO
• Madeline Danielle Clausell
• Deborah L Clay
• Rayna Ann Clay, M.D.

• Family Nurse Practitioner in Riverview, FL
• Providers in Riverview, FL by specialty
• Family Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.