Individual
JESSICA CLAKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
3303 W ILLINOIS AVE STE 22, MIDLAND, TX 79703-6232
(432) 681-7613
(432) 699-6290
Mailing address
1005 MANOR ST, MIDLAND, TX 79703-4940
(432) 260-9729
Taxonomy
Speciality
Code
Description
License number
State
163WC1500X
Community Health Registered Nurse
Primary
808458
TX
Other
Enumeration date
11/04/2022
Last updated
11/04/2022
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