Hailey a. Clark FNP-C LLC

Primary specialty

Health Service Clinic/CenterTaxonomy code 261QH0100X

Legal business name

HAILEY A. CLARK FNP-C LLC

Practice address

814 Pancheri Dr
Idaho Falls, ID 83402-3344

Phone

(208) 223-1049

NPI assigned

Mar 5, 2021

Organization subpart

No

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

Authorized official

Name

Mrs. Hailey Anne Clark, FNP-C

Title

Owner

Phone

(208) 223-1049

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Hailey Anne Jensen, NP-C

  • Gynecologic Oncology Physician
  • Idaho Falls, ID
  • NPI 1487125969
  NPD

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

{
    "created_epoch": "1614902400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1614902400000",
    "number": "1689269177",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4060 DUANE ST",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834011846",
            "telephone_number": "208-223-1049"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "814 PANCHERI DR",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834023344",
            "telephone_number": "208-223-1049"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HAILEY A. CLARK FNP-C LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-03-05",
        "last_updated": "2021-03-05",
        "certification_date": "2021-03-05",
        "status": "A",
        "authorized_official_last_name": "CLARK",
        "authorized_official_first_name": "HAILEY",
        "authorized_official_middle_name": "ANNE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "208-223-1049",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "FNP-C"
    },
    "taxonomies": [
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hailey Guzzetti
• Matthew Hagan, M.D.
• Jacklyn Hagg, AGACNP
• Lynetta Ruth Hagler, LCSW
• Avery Haile
• Chelsey Jo Hale, LMSW
• Marta Lucia Marie Hale, RT
• Zackary M Hale, AU.D
• Jean R Halford
• Christina Lynn Hall, IS

• Health Service Clinic/Center in Idaho Falls, ID
• Providers in Idaho Falls, ID by specialty
• Health Service Clinic/Center in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2021; 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.