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JENNIFER M CLARK CRNP
Family >> Nurse Practitioner >> Physician Assistants & Advanced Practice Nursing ProvidersRegistrant NPI Number: 1407186554
Individual Registrant: JENNIFER M CLARK CRNP
Gender: F
Not Sole Proprietor
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
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
Tel: 717-339-2390 Fax: 717-359-4178
Registration Information:
NPI: 1407186554
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| Y | 363LF0000X | Physician Assistants & Advanced Practice Nursing Providers Nurse Practitioner Family | PA | SP010597 |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
| GATEWAY-WMG | 1587216 | PA | 01 |
| HIGHMARK BLUE SHIELD | 2499067 | PA | 01 |
| CAREFIRST MD BCBS | 960064 | MD | 01 |
