Individual
JEANETTE MARIE CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
3811 E BELL RD STE 111, PHOENIX, AZ 85032-2158
(208) 270-2178
Mailing address
24611 N 144TH AVE, SURPRISE, AZ 85387-7033
(208) 270-2178
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN-173739
MT
363LA2200X
Adult Health Nurse Practitioner
Primary
334234
AZ
Other
Enumeration date
07/28/2025
Last updated
02/17/2026
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