Individual
JENNIE S CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA C
Contact information
Practice address
1940 ALCOA HWY STE E260, KNOXVILLE, TN 37920-2266
(865) 305-6955
(865) 305-8238
Mailing address
PO BOX 440547, NASHVILLE, TN 37244-0547
(865) 670-6199
(865) 670-6188
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
1120
TN
363AS0400X
Surgical Physician Assistant
Primary
1120
TN
Other
Enumeration date
08/24/2005
Last updated
11/20/2023
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