Individual
MS. JEAN A. CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN, MS, CCRN, APRN
Contact information
Practice address
1 MEDICAL CENTER DR, LEBANON, NH 03756-1000
(603) 650-7390
(603) 650-6346
Mailing address
1 MEDICAL CENTER DR, LEBANON, NH 03756-1000
(603) 650-7390
(603) 650-6346
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
013011-23
NH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0NP2131
—
VT
05
—
30340591
—
NH
Enumeration date
06/28/2006
Last updated
07/29/2009
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