Individual
JENNIFER LEIGH CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AGNP
Contact information
Practice address
100 LAKE TRAVERSE DR, SISSETON, SD 57262-7046
(605) 698-7606
Mailing address
100 LAKE TRAVERSE DR, SISSETON, SD 57262-7046
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
4704290820
MI
363L00000X
Nurse Practitioner
Primary
4704290820
MI
Other
Enumeration date
05/28/2017
Last updated
02/22/2024
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