Individual
JESSICA CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
205 S MACDADE BLVD APT J, GLENOLDEN, PA 19036-2019
(215) 478-3207
Mailing address
205 S MACDADE BLVD APT J, GLENOLDEN, PA 19036-2019
(215) 478-3207
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
PN307048
PA
Other
Enumeration date
03/17/2025
Last updated
03/17/2025
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