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Contact Information

JENNIFER S CLARK, FNP-C
1840 MARTIN LUTHER KING JR BLVD STE C4
CHAPEL HILL, NC27514
 Phone: 919-510-6679
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Family

363LF0000X 50 Nurse Practitioner
Indicates primary specialty

NPI Profile & details for JENNIFER S CLARK · (Female)

NPI # 1245567247
Status Active
Credentials FNP-C (Family Nurse Practitioner, Certified)
Entity Individual
Enumeration date 11/11/2009
Last updated 06/13/2022 - About 4 years ago
Sole proprietor 1 No
Identifiers
  • NC License # 5004547
  • NC Medicaid 1245567247
Hospital affiliation(s)
  • PERSON MEMORIAL HOSPITAL - (Acute Care)
    615 RIDGE RD
    ROXBORO, NC 27573
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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