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JENNIFER M CLARK CRNP

Family >> Nurse Practitioner >> Physician Assistants & Advanced Practice Nursing Providers

Registrant NPI Number: 1407186554

Individual Registrant:
 JENNIFER M CLARK CRNP
Gender: F
Not Sole Proprietor

Location and contact information for practice:
300 W KING ST SUITE C LITTLESTOWN, PA 17340-1446 US
Tel: 717-339-2390  Fax: 717-359-4178

Contact information for business:
3421 CONCORD RD  YORK, PA 17402-9001 US
Tel: 717-339-2390  Fax: 717-359-4178

Registration Information:
NPI: 1407186554
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y363LF0000XPhysician Assistants & Advanced Practice Nursing Providers
Nurse Practitioner
Family
PASP010597

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType
GATEWAY-WMG1587216PA01
HIGHMARK BLUE SHIELD2499067PA01
CAREFIRST MD BCBS960064MD01




HEALTH CARE JOBS PA - Page 1



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