Nathaniel Robert Clark, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

0001219375 Issued in VA

Practice address

Naval Hospital 6000 West Hwy 98
Pensacola, FL 32512-0003

Phone

(240) 898-7288

Fax

(850) 505-6288

NPI assigned

Feb 15, 2011

Last updated

Feb 15, 2011By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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)

Enrolled

Credentials

Certified Registered Nurse

State licenses

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

{
    "created_epoch": "1297728000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1297728000000",
    "number": "1891092516",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "NAVAL HOSPITAL 6000 WEST HWY 98",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325120003",
            "telephone_number": "240-898-7288",
            "fax_number": "850-505-6288"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "NAVAL HOSPITAL 6000 WEST HWY 98",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325120003",
            "telephone_number": "240-898-7288",
            "fax_number": "850-505-6288"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "NATHANIEL",
        "middle_name": "ROBERT",
        "name_prefix": "Mr.",
        "credential": "CRNA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-02-15",
        "last_updated": "2011-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "VA",
            "license": "0001219375",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jessica Lynn Clark
• John Henry Clark, CRNA
• Leigh Dell Clark, LMHC
• Melea Hopelyn Clark, PHARMD, RPH
• Michael Eugene Clark, CRNA
• Pamela Stacie Clark, COTA
• Richard O Clark, PAC
• Sarah Shivers Clark, NP-C
• William Buren Clark, MD
• Zelnnetta Clark

• Certified Registered Nurse Anesthetist in Pensacola, FL
• Providers in Pensacola, FL by specialty
• Certified Registered Nurse Anesthetist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2011; 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.