Adrienne Jenkins Clark, APRN-C
Individual provider Active NPI Family Nurse Practitioner · Walker, LA
NPI 1972129195 · NPPES record last updated Jun 29, 2020
Key facts
- NPI
- 1972129195
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 213822 (LA)
- Practice address
- 10053 Florida Blvd Unit 627
Walker, LA 70785-5097 - Phone
- (225) 335-4085
- NPI assigned
- Jun 23, 2020
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in LA
- Eligible to order & refer
- Part B services: No · DME: Yes · Home health: No · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20201007000013 | LA | Practitioner - Nurse Practitioner | 7214356518 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Neighborhood Health Primary Care, LLC | Current |
Accepting new patients |
Locations
307 3rd St
Baton Rouge, LA 70801
Phone (225) 366-6396
16158 Airline Hwy
Ste 103
Prairieville, LA 70769
Phone (225) 963-9355
Interoperability endpoints
- adrienne.clark@56257199144964.direct.elationemr.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 213822 | LA | Yes |
Addresses
Primary practice location
10053 Florida Blvd Unit 627
Walker, LA 70785-5097
Mailing address
PO Box 627
Walker, LA 70785-0627
Phone (225) 335-4085
Other providers in Walker, LA
- Alex Anthony Capace
- Melissa Lynn Carson
- Courtney Chambers
- Children'S International, LLC
- Michelle Marie Civello
- Jordan Nicole Claverie
- Holly Colclough
- Dennis Cutrer
- Jennifer J Daniel
- Claudia Noelle Carter Davis
All providers in Walker, LA · Family Nurse Practitioner in Louisiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 29, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.