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Active NPI 1982767604 Individual Practitioner Female Practitioner

Nicole Christine Clark , LPN

Licensed Practical Nurse • Syracuse, NY

Professional Overview & Biography Verified Profile Summary

Nicole Clark, LPN is a registered healthcare professional specializing in Licensed Practical Nurse in Syracuse, NY. Practice services are available at 241 LORRAINE AVE under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

241 Lorraine Ave

Syracuse, NY 132103229

Telephone 3158635885

Specialty Benchmarks & Practice Insights

Comparative analytics for Licensed Practical Nurse in Syracuse, NY

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 8.0 Yrs
Regional Practice Density
493 Specialists

Practicing in Syracuse, NY (23738 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Licensed Practical Nurse Primary Specialty

NUCC Taxonomy Code: 164W00000X

State License NY 251148-1

An individual with post-high school vocational training and practical experience in the provision of nursing care at a level less than that required for certification as a Registered Nurse. Requirements for education, experience, licensure, and job responsibilities vary among the states.

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid State Provider ID
02120758 (NY)

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

1 Associated Practitioners
Veronica Ellis , RN

Registered Nurse - Home Health

NPI 1851718233

Registered Nurse

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

6 Historical Events
✅
NPI Profile Active July 09, 2007

NPI status registered as active in NPPES database

📍
Updated Practice Location July 09, 2007

Registered at 241 LORRAINE AVE, SYRACUSE, NY 132103229 (Tel: 3158635885)

📍
Updated Business Mailing Address July 09, 2007

Registered at 241 LORRAINE AVE, SYRACUSE, NY 132103229 (Tel: 3158635885)

👤
Provider Name / Credentials Updated July 09, 2007

Recorded as NICOLE CLARK, LPN

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) July 09, 2007

Licensed Practical Nurse (License #251148-1 in NY)

🟢
Initial NPI Registration & Enumeration December 18, 2006

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

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NPI Administrative Meta

NPI Number: 1982767604
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: December 18, 2006
Last Update: July 09, 2007
Sole Proprietor: No
Update or Correct Profile

Mailing Address

241 Lorraine Ave

Syracuse, NY 132103229

Phone: 3158635885

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.