Individual provider · Type 1 NPI

Jennifer Rae Clark, CPNP-PC

Pediatric Nurse Practitioner · League City, TX

NPI number 1982249926 Active

Practice location

2800 E League City Pkwy Apt 216
League City, TX 77573-1676

Mailing address

2251 FM 646 Rd W Ste 155
Dickinson, TX 77539-3256

Specialties and licenses

TaxonomyCodeLicense
Pediatric Nurse Practitioner Primary 363LP0200XAP142270 (TX)

Pediatric Nurse Practitioner: Definition to come...

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About NPI 1982249926

Jennifer Rae Clark, CPNP-PC's National Provider Identifier is 1982249926, issued on Nov 13, 2019. The primary taxonomy on file is Pediatric Nurse Practitioner (363LP0200X), and the practice location is in League City, TX. The record was last updated on Nov 13, 2019.