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Individual
JESSICA MARIE CLARK
Active
Individual
JESSICA MARIE CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
4583
TN
207LP3000X
Pediatric Anesthesiology Physician
Primary
4583
TN
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
Q058065
—
TN
Enumeration date
04/20/2020
Last updated
06/19/2026
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