Individual
JACQUELYN M CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
1228 WALNUT ST APT 2, CINCINNATI, OH 45202-7135
(513) 766-2631
Mailing address
PO BOX 14096, CINCINNATI, OH 45250-0096
(513) 766-2631
Taxonomy
Speciality
Code
Description
License number
State
163WC0200X
Critical Care Medicine Registered Nurse
Primary
RN450440
OH
Other
Enumeration date
03/09/2020
Last updated
03/09/2020
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