Individual
MRS. JENNIFER RUTH CLARKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
5120 BEATLINE RD STE A, LONG BEACH, MS 39560-3815
(228) 868-4287
(228) 868-4293
Mailing address
5 CHLOE CT, LONG BEACH, MS 39560-5351
(228) 806-4181
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
R855220
MS
Other
Enumeration date
11/02/2010
Last updated
11/02/2010
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