Individual provider · Type 1 NPI
Jessica Lane Clark, PMHNP
Psychiatric/Mental Health Nurse Practitioner · Athens, GA
NPI number
1093387664
Active
Practice location
745 S Milledge Ave Ste 1A
Athens, GA 30605-1292
Fax (706) 498-9568
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner Primary | 363LP0808X | APRN-NP222359 (GA) |
| Registered Nurse | 163W00000X | RN222359 (GA) |
Psychiatric/Mental Health Nurse Practitioner: Definition to come...
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About NPI 1093387664
Jessica Lane Clark, PMHNP's National Provider Identifier is 1093387664, issued on Jul 13, 2021. The primary taxonomy on file is Psychiatric/Mental Health Nurse Practitioner (363LP0808X), and the practice location is in Athens, GA. The record was last updated on Feb 9, 2026.