Angela Marie Clark, DNP, APRN, PMHNP-BC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

6229 Issued in MN

Practice address

5255 Members Pkwy NW
Rochester, MN 55901-8381

Phone

(507) 218-3701

Fax

(507) 258-5503

NPI assigned

Oct 9, 2018

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

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• St. Croix Psychiatric, LLC

  • Psychiatry Physician
  • Woodbury, MN
  • NPI 1881849586
  NPD
• Prairiecare LLC

  • Psychiatric Hospital
  • Brooklyn Park, MN
  • NPI 1215182928
  NPD (past)
• Zumbro Valley Health Center

  • Community/Behavioral Health Agency
  • Rochester, MN
  • NPI 1801961263
  NPD (past)

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

{
    "created_epoch": "1539043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1570492800000",
    "number": "1275008914",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5255 MEMBERS PKWY NW",
            "city": "ROCHESTER",
            "state": "MN",
            "postal_code": "559018381"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5255 MEMBERS PKWY NW",
            "city": "ROCHESTER",
            "state": "MN",
            "postal_code": "559018381",
            "telephone_number": "507-218-3701",
            "fax_number": "507-258-5503"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "ANGELA",
        "middle_name": "MARIE",
        "credential": "DNP, APRN, PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-10-09",
        "last_updated": "2019-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MN",
            "license": "6229",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• City Hoppa LLC
• Jeremy M. Clain, M.D.
• Jonathan E Clain, M.D.
• Frederick W. Clare, PA-C
• Clarity Counseling Center
• Brittney Clark, M.D.
• Darron Clark
• David Steven Clark
• Dawn Clark
• Ellie Ann Clark, OTD, OTR/L

• Psychiatric/Mental Health Nurse Practitioner in Rochester, MN
• Providers in Rochester, MN by specialty
• Psychiatric/Mental Health Nurse Practitioner in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2019; 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.