Individual
JENNIFER MARY JOY CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-BC
Contact information
Practice address
8308 BURLINGTON DR, TROY, IL 62294-4003
(618) 410-5317
Mailing address
8308 BURLINGTON DR, TROY, IL 62294-4003
(618) 410-5317
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
209023558
IL
Other
Enumeration date
09/10/2021
Last updated
09/10/2021
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