K. Clark Family Medical PLLC
NPI 1700566577ActiveOrganization· Nurse Practitioner, Family· Queen Creek, AZ
Nurse Practitioner, Family in Queen Creek, Arizona, registered in NPPES in July 2023. The authorized official on file is Kailynn Clark, NP, Provider. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1700566577 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Jul 18, 2023 |
| Last updated in NPPES | May 11, 2024 |
| Certified by provider | May 11, 2024 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Nurse Practitioner, Family Primary | 363LF0000X | — | — |
| Nurse Practitioner, Psych/Mental Health | 363LP0808X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 4, 2026 | No match | — |
| New York OMIG · Nov 4, 2026 | No match | — |
| Ohio Medicaid · Nov 4, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 4, 2026 | No match | — |
| Washington HCA · Nov 4, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Clinic/Group Practice (AZ) |
|---|
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