Individual
JENNIFER DAWN CLYATT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
APRN, AGNP-C
Contact information
Practice address
4740 EXPLORATION AVE, LAKELAND, FL 33812-3319
(863) 666-9020
(863) 606-0887
Mailing address
4740 EXPLORATION AVE, LAKELAND, FL 33812-3319
(863) 666-9020
(863) 606-0887
Taxonomy
Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
Primary
APRN11001024
FL
363LP2300X
Primary Care Nurse Practitioner
APRN1101024
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
APRN11001024
MED LICENSE
FL
Enumeration date
05/20/2019
Last updated
01/21/2026
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