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Individual
JESSICA CLARKE
Active
Individual
JESSICA CLARKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
4704290365
MI
208000000X
Pediatrics Physician
20173296
MI
363L00000X
Nurse Practitioner
Primary
4704290365
MI
363LP0200X
Pediatric Nurse Practitioner
4704290365
MI
Other
Enumeration date
11/09/2017
Last updated
02/27/2026
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