Individual provider · NPI-1
Jennifer M Clark, CRNP
Nurse Practitioner, Family · Littlestown, PA
NPI number1407186554
StatusActive
Last updated in NPPESJun 10, 2016
Details
- NPI
- 1407186554
- Entity type
- Individual (NPI-1)
- Name
- Jennifer M Clark
- Credential
- CRNP
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Jan 12, 2010
- Last updated
- Jun 10, 2016
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363LF0000X | Nurse Practitioner, Family | SP010597 | PA | Yes |
Practice location
300 W King StSuite C
Littlestown, PA 17340-1446
Phone 717-339-2390 · Fax 717-359-4178
Mailing address
3421 Concord RdYork, PA 17402-9001
Phone 717-339-2390 · Fax 717-359-4178
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.