Organization
PREVAIL PSYCHIATRIC SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JESSICA CLARK DNP (PSYCHIATRIC NURSE PRACTITIONER)
(651) 724-2905
Entity
Organization
Contact information
Practice address
1978 ADOLPHUS ST, MAPLEWOOD, MN 55117-1904
(651) 724-2905
Mailing address
1978 ADOLPHUS ST, MAPLEWOOD, MN 55117-1904
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
—
—
Other
Enumeration date
11/28/2022
Last updated
11/28/2022
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