LISA LYNN CLARK CRNA
NPI 1336100130
Nurse Anesthetist, Certified Registered in Dothan, AL

Q: What is Lisa Clark's NPI number?

The NPI number for Lisa Clark is 1336100130. It was assigned to this individual provider in the NPPES registry on March 31, 2006.

Q: What is Lisa Clark's specialty?

The primary specialty registered for this NPI is Nurse Anesthetist, Certified Registered with taxonomy code 367500000X.

Q: When was this NPI record last updated?

The NPPES record for Lisa Clark was last updated on July 25, 2011. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since March 31, 2006

4370 W MAIN STREET, DOTHAN, AL 36305(334) 793-5000(334) 615-8428 Get Directions Write a Review

NPPES record last updated: July 25, 2011. Verified against the NPPES registry weekly; last sync: August 02, 2026.

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About Lisa Lynn Clark Crna NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

LISA LYNN CLARK CRNA (NPI 1336100130) is an individual nurse anesthetist, certified registered in Dothan, Alabama, licensed in Alabama (1054427) and active in the NPI registry since March 2006.

NPPES Registry Identity

NPI1336100130

Entity TypeIndividualFemale

Primary Taxonomy367500000X

Provider Legal NameLISA LYNN CLARKCredential: CRNA

Location Address4370 W MAIN STREETDothan, AL 36305

Mailing AddressPo Box 6907Dothan, AL 36302 · (334) 793-5000 · Fax (334) 615-8428

Phone(334) 793-5000

Fax(334) 615-8428

Sole ProprietorNo

Enumeration DateMarch 31, 2006

Last NPPES UpdateJuly 25, 2011

✔ NPI 1336100130 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Anesthetist, Certified RegisteredPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code367500000X

License✔ Licensed in AL · 1054427

Definition

(1) A licensed registered nurse with advanced specialty education in anesthesia who, in collaboration with appropriate health care professionals, provides preoperative, intraoperative, and postoperative care to patients and assists in management and resuscitation of critical patients in intensive care, coronary care, and emergency situations. Nurse anesthetists are certified following successful completion of credentials and state licensure review and a national examination directed by the Council on Certification of Nurse Anesthetists. (2) A registered nurse who is qualified by special training to administer anesthesia in collaboration with a physician or dentist and who can assist in the care of patients who are in critical condition.

4370 W MAIN STREET, Dothan, AL 36305

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Other Identifiers 7

Medicaid051515740AL

Medicare UPINR90182

Medicare PIN051515740AL

OtherP00078968Rr Medicare

Other51515740AL · Blue Cross Blue Shield

Medicaid301239500FL

Medicaid000652451BGA

Other Providers at the Same Location NPPES 12

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

JANITH S DEHAVEN CRNA

Nurse Anesthetist, Certified Registered