Individual
MS. JACQUELINE MARIE CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
700 19TH ST S, BIRMINGHAM, AL 35233-1927
(205) 933-8101
(205) 558-4783
Mailing address
1709 1ST CT W, BIRMINGHAM, AL 35208-5201
(205) 933-8101
(205) 558-4783
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
1-051962
AL
Other
Enumeration date
01/17/2013
Last updated
01/17/2013
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