Individual
MS. JODEAN CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C, AOCN
Contact information
Practice address
3426 N ROOSEVELT BLVD, KEY WEST, FL 33040-4224
(786) 596-2000
(786) 279-7778
Mailing address
PO BOX 743144, ATLANTA, GA 30374-3144
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
APRN11041589
FL
363L00000X
Nurse Practitioner
Primary
RN150178
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003219379A
—
GA
05
—
003219379B
—
GA
01
—
G12301A
MEDICARE PTAN
GA
Enumeration date
04/25/2019
Last updated
04/06/2026
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