Christianna J Clark

Primary specialty

School Registered NurseTaxonomy code 163WS0200X

License

RN111772 Issued in AZ

Practice address

4100 W 20TH St
Yuma, AZ 85364-4800

Phone

(928) 502-5700

Fax

(928) 502-5869

NPI assigned

Aug 23, 2017

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

Other names 1

• Christi Clark Other name

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": "1503446400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1437676293",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4100 W 20TH ST",
            "city": "YUMA",
            "state": "AZ",
            "postal_code": "853644800",
            "telephone_number": "928-502-5700",
            "fax_number": "928-502-5869"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4100 W 20TH ST",
            "city": "YUMA",
            "state": "AZ",
            "postal_code": "853644800",
            "telephone_number": "928-502-5700",
            "fax_number": "928-502-5869"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "CHRISTIANNA",
        "middle_name": "J",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-08-23",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WS0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, School",
            "state": "AZ",
            "license": "RN111772",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CHRISTI",
            "last_name": "CLARK",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Mahealani Carla Chun, SLPA
• Justin Church, DMD
• Kipp Owens Church, D.M.D
• Jodie Cicco, PT, DPT
• City of Yuma
• Hugh Rock Clark, DDS
• Pamela Clark
• Rebecca Clark, FOSTER PARENT
• Rick G Clark, DO
• Michelle Marie Class

• School Registered Nurse in Yuma, AZ
• Providers in Yuma, AZ by specialty
• School Registered Nurse in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.