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1356810360
THRISHANNA CLARK
JACKSON, MS
NPI
1356810360
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363LP0808X Nurse Practitioner, Psych/Mental Health
(Licence: MS 902942)
Enumeration Date
2018-11-19
Last Update Date
2018-11-19
Business Address
THRISHANNA CLARK NP
3502 W NORTHSIDE DR
JACKSON, MS 39213-4454
Phone number: 601-362-5321
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Mailing Address
THRISHANNA CLARK NP
115 WHIPPOORWILL RD
BRANDON, MS 39047-6428
Phone number: 601-665-2953
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