Individual
JESSICA CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNP
Contact information
Practice address
911 E 20TH ST STE 300, SIOUX FALLS, SD 57105-1045
(605) 504-1100
Mailing address
2420 E BAXTER CIR, SIOUX FALLS, SD 57108-4844
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
CP003004
SD
Other
Enumeration date
10/26/2023
Last updated
11/21/2023
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