Individual
JESSICA LEE CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
6011 CIELO RNCH, SAN ANTONIO, TX 78218-4161
(970) 301-1073
Mailing address
6011 CIELO RNCH, SAN ANTONIO, TX 78218-4161
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
846871
TX
Other
Enumeration date
02/19/2018
Last updated
02/19/2018
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