Nancy Jean Clark, IBCLC

Primary specialty

Lactation Consultant (Non-RN)Taxonomy code 174N00000X

License

18910401 Issued in VA

Practice address

7402 Flemingwood LN
Springfield, VA 22153-1701

Phone

(703) 731-8843

NPI assigned

Sep 3, 2012

Sex

Female

Sole proprietor

Yes

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": "1346630400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1346630400000",
    "number": "1184973372",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7402 FLEMINGWOOD LN",
            "city": "SPRINGFIELD",
            "state": "VA",
            "postal_code": "221531701",
            "telephone_number": "703-731-8843"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7402 FLEMINGWOOD LN",
            "city": "SPRINGFIELD",
            "state": "VA",
            "postal_code": "221531701",
            "telephone_number": "703-731-8843"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "NANCY",
        "middle_name": "JEAN",
        "name_prefix": "Mrs.",
        "credential": "IBCLC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-09-03",
        "last_updated": "2012-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174N00000X",
            "taxonomy_group": "",
            "desc": "Lactation Consultant, Non-RN",
            "state": "VA",
            "license": "18910401",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ann-Marie Clark
• Destiny Clark
• Jordan Amanda Clark, RBT
• Kerrianne Maria Clark, AU.D.
• Megan Clark, OTR/L, CNT
• Trevor Joseph Claveau, RBT
• Dawn Clements, RBT
• Jenna Clemons, PHARMD
• Orion Clouden
• Coach for Seniors Inc.

• Lactation Consultant (Non-RN) in Springfield, VA
• Providers in Springfield, VA by specialty
• Lactation Consultant (Non-RN) in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2012; 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.