Individual
MRS. JO ANN CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
104 HOSPITAL DRIVE, MAGNOLIA, AR 71753
(870) 235-3555
(870) 562-2560
Mailing address
PO BOX 629, MAGNOLIA, AR 71754
(870) 235-3555
(870) 562-2560
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
A01754
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
157033758
—
AR
Enumeration date
06/26/2006
Last updated
04/27/2022
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