Individual
MS. JENNIFER SELLECK CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
1840 MARTIN LUTHER KING JR BLVD STE C4, CHAPEL HILL, NC 27514
(919) 510-6679
Mailing address
1840 MARTIN LUTHER KING JR BLVD STE C4, CHAPEL HILL, NC 27514-7415
(919) 510-6679
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
5004547
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1245567247
—
NC
Enumeration date
11/11/2009
Last updated
06/13/2022
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