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Individual

JENNIFER M CLARK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CRNP

Contact information

Practice address
300 W KING ST, SUITE C, LITTLESTOWN, PA 17340-1446
(717) 339-2390
(717) 359-4178
Mailing address
3421 CONCORD RD, YORK, PA 17402-9001
(717) 339-2390
(717) 359-4178

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
SP010597
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1587216
GATEWAY-WMG
PA
01
2499067
HIGHMARK BLUE SHIELD
PA
01
960064
CAREFIRST MD BCBS
MD
Enumeration date
01/12/2010
Last updated
06/10/2016
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