| NPI | 1851113716 |
|---|---|
| Former Name | JENNIFER LYNN CLARK |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WA AP70015355) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: ID 53657) |
| Enumeration Date | 2024-10-30 |
| Last Update Date | 2026-04-02 |