| Jennifer Rae Clark, CPNP-PC | |
|
2800 E League City Pkwy Apt 216, League City, TX 77573-1676 | |
| (907) 350-8538 | |
| Not Available |
| Full Name | Jennifer Rae Clark |
|---|---|
| Gender | Female |
| Speciality | Nurse Practitioner - Pediatrics |
| Location | 2800 E League City Pkwy Apt 216, League City, Texas |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1982249926 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363LP0200X | Nurse Practitioner - Pediatrics | AP142270 (Texas) | Primary |
| Entity Name | Privia Medical Group Gulf Coast Pllc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1578969465 PECOS PAC ID: 4688999022 Enrollment ID: O20150206000763 |
| Mailing Address | Practice Location Address |
|---|---|
| Jennifer Rae Clark, CPNP-PC 2251 Fm 646 Rd W Ste 155, Dickinson, TX 77539-3256 Ph: (907) 350-8538 | Jennifer Rae Clark, CPNP-PC 2800 E League City Pkwy Apt 216, League City, TX 77573-1676 Ph: (907) 350-8538 |
Mrs. Laura Day Ellender, RN, CEN, FNP-C Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 6465 S Shore Blvd, League City, TX 77573 Phone: 281-538-7735 | |
Tammy Renee Brown, MSN, RN, ACNP-C Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 6117 Carlisle Ln, League City, TX 77573 Phone: 832-628-7943 | |
Mona Kidwell, N.P. Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 2785 Gulf Fwy S, Suite 115, League City, TX 77573 Phone: 832-816-1370 | |
Hilma Peiso Bochantin, FNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 2240 Gulf Fwy S, League City, TX 77573 Phone: 832-505-1234 | |
Lorelei Marquez Liquigan, NURSE PRACTITIONER Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 805 Maplewood Dr, League City, TX 77573 Phone: 281-898-3436 | |
Cheryl Brackens, NP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 2955 Gulf Fwy S, League City, TX 77573 Phone: 713-935-0333 | |
Kathleen Nicole Henry, MSN, FNP-C Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 2212 Lakewind Ln, League City, TX 77573 Phone: 832-221-5042 |