Kristen Marie Clark

Primary specialty

Neonatal Nurse PractitionerTaxonomy code 363LN0000X

License

1181713 Issued in TX

Practice address

7600 Fannin St
Houston, TX 77054-1906

Phone

(713) 790-1234

NPI assigned

Apr 17, 2023

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

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": "1681689600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739318400000",
    "number": "1326734948",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2811 DECROS PT",
            "city": "RICHMOND",
            "state": "TX",
            "postal_code": "774061949",
            "telephone_number": "281-224-1500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7600 FANNIN ST",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770541906",
            "telephone_number": "713-790-1234"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2722 Village Pl",
            "address_purpose": "LOCATION",
            "city": "Birmingham",
            "state": "AL",
            "postal_code": "352115701",
            "country_code": "US",
            "telephone_number": "281-224-1500",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CLARK",
        "first_name": "KRISTEN",
        "middle_name": "MARIE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-04-17",
        "last_updated": "2025-02-12",
        "certification_date": "2025-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "AL",
            "license": "1-188505",
            "primary": false
        },
        {
            "code": "163WN0002X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Neonatal Intensive Care",
            "state": "AL",
            "license": "1-188505",
            "primary": false
        },
        {
            "code": "363LN0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Neonatal",
            "state": "TX",
            "license": "1181713",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennie Clark, APRN
• Jerry D Clark, LPC
• Jessica Clark, MS
• John Clark, M.D.
• Kourtney Gisell Clark, AUD
• Latosha Clark
• Madeline Elizabeth Clark, MD
• Marie A. Clark, M.D.
• Marylou Clark
• Matthew David Clark, PHARM.D.

• Neonatal Nurse Practitioner in Houston, TX
• Providers in Houston, TX by specialty
• Neonatal Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2025; 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.