Individual
MRS. JENNA MARIE CLARK
Active
Individual
MRS. JENNA MARIE CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NNP
Taxonomy
Speciality
Code
Description
License number
State
163WL0100X
Lactation Consultant (Registered Nurse)
RN 343251 L-88563
OH
363LN0000X
Neonatal Nurse Practitioner
Primary
APRN.CNP.0030509
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0015277
—
OH
Enumeration date
01/18/2016
Last updated
05/13/2024
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