Individual
JESSICA CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PMHNP
Contact information
Practice address
103 VALLEY CENTER DR, STAUNTON, VA 24401-5080
(540) 332-8211
Mailing address
PO BOX 2500, STAUNTON, VA 24402-2500
(540) 332-8211
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
0024178280
VA
Other
Enumeration date
09/23/2019
Last updated
09/23/2019
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