Erin Kae Clark, ATC
Individual provider Active NPI Athletic Trainer · Whitewater, WI
NPI 1629508908 · NPPES record last updated Jun 19, 2017
Key facts
- NPI
- 1629508908
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Athletic Trainer 2255A2300X
- License
- 855-39 (WI)
- Practice address
- 800 W Main St
Williams Center 105G
Whitewater, WI 53190 - Phone
- (262) 472-1138
- NPI assigned
- Jun 19, 2017
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 855-39 | WI | MD | Athletic Trainer |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | 855-39 | WI | Yes |
Addresses
Primary practice location
800 W Main St
Williams Center 105G
Whitewater, WI 53190
Mailing address
W9547 Skogen Rd
Cambridge, WI 53523-9756
Phone (920) 296-9183
Other providers in Whitewater, WI
- Maria Ann Brown
- Laura B Carney
- Chrysalis Psychotherapy LLC
- Judith Ciasto
- City of Whitewater
- Kelsey Clark
- Jason A Cliffgard
- Clinical Chiropractic of Whitewater, S.C.
- Jeffrey Douglas Cook
- Abby L Curtis
All providers in Whitewater, WI · Athletic Trainer in Wisconsin
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 19, 2017. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.