Individual
JESSICA KATE CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
1007 MARY ST, WAYCROSS, GA 31503-3823
(800) 342-8168
Mailing address
1007 MARY ST, WAYCROSS, GA 31503-3823
(800) 342-8168
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
RN215514
GA
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
RN215514
GA
Other
Enumeration date
02/08/2019
Last updated
04/03/2023
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