| Ms Jennifer Ann Clark, | |
|
330 Warner Dr, Lewiston, ID 83501-4441 | |
| (208) 746-0193 | |
| (208) 746-7074 |
| Full Name | Ms Jennifer Ann Clark |
|---|---|
| Gender | Female |
| Speciality | Audiologist |
| Location | 330 Warner Dr, Lewiston, Idaho |
| Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053584292 | NPI | - | NPPES |
| AU022 | Other | ID | BLUE CROSS OF ID |
| 000010170154 | Other | ID | REGENCE BLUESHIELD OF ID |
| 8560278 | Medicaid | WA | |
| 808195700 | Medicaid | ID | |
| 1580017 | Other | ID | MEDICARE ID |
| P00678807 | Other | ID | RAILROAD MEDICARE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 231H00000X | Audiologist | AUD-1728 (Idaho) | Primary |
| Mailing Address | Practice Location Address |
|---|---|
| Ms Jennifer Ann Clark, 330 Warner Dr, Lewiston, ID 83501-4441 Ph: (208) 746-0193 | Ms Jennifer Ann Clark, 330 Warner Dr, Lewiston, ID 83501-4441 Ph: (208) 746-0193 |
Simon Audiology & Tinnitus Llc Audiologist Medicare: Medicare Enrolled Practice Location: 1022 Bryden Ave, Lewiston, ID 83501 Phone: 208-746-7022 Fax: 208-746-2886 | |
Mrs. Anne Kristin Simon, M.S. Audiologist Medicare: Accepting Medicare Assignments Practice Location: 1022 Bryden Ave, Lewiston, ID 83501 Phone: 208-746-7022 Fax: 208-746-2886 |