Kristen Leigh Clark, LPN

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

313915-1 Issued in NY

Practice address

105 Edgewood Ave
Buffalo, NY 14220-1765

Phone

(716) 435-1175

NPI assigned

Sep 25, 2013

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

State licenses

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

{
    "created_epoch": "1380067200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1380067200000",
    "number": "1174959910",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 EDGEWOOD AVE",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142201765",
            "telephone_number": "716-435-1175"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 EDGEWOOD AVE",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142201765",
            "telephone_number": "716-435-1175"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "KRISTEN",
        "middle_name": "LEIGH",
        "name_prefix": "Mrs.",
        "credential": "LPN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-09-25",
        "last_updated": "2013-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "313915-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Donna Mae Clark
• Elaine Clark
• Eric Robert Clark
• Jarmel Clark
• John H Clark, MD
• Kristin L Clark, MD
• Lauren J Clark, M.S.
• Scott D Clark, A.N.P.
• Scott Earl Clark, RPAC
• Tracy Michelle Clark, MSW

• Licensed Practical Nurse in Buffalo, NY
• Providers in Buffalo, NY by specialty
• Licensed Practical Nurse in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2013; 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.