Provider Type Icon

ROZELLA REBECCA CLARK NPI 1790829224


NPI Information

NPI: 1790829224
Provider Name: ROZELLA REBECCA CLARK
Classification: Physician Assistant - 363A00000X
Entity Type: Individual
Address:
1024 S LEMAY AVE
FORT COLLINS, CO
ZIP 80524
Phone: (970) 495-7000
Get Directions

Rozella Rebecca Clark is a physician assistant in Fort Collins, CO. The provider is a physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. Rozella Rebecca Clark NPI is 1790829224. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

1024 S LEMAY AVE
FORT COLLINS, CO
ZIP 80524-929
Phone: (970) 495-7000
Fax: (303) 306-7753

The enumeration date for this NPI number is 2/17/2007 and was last updated on 11/19/2015.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1363A00000XPhysician AssistantPA1380NEVADANo
2363A00000XPhysician Assistant5221GEORGIANo
3363A00000XPhysician AssistantPA.0004163COLORADOYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
199487594MEDICAIDCOLORADO
2439933YLA0MEDICARE PINCOLORADO

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.