Jessica Clark, is a
Licensed Practical Nurse based in Glenolden, Pennsylvania. Jessica Clark is licensed to practice in Pennsylvania (license number PN307048) and her current practice location is
205 S Macdade Blvd Apt J, Glenolden, Pennsylvania. She can be reached at her office (for appointments etc.) via phone at
(215) 478-3207.
NPI number for Jessica Clark is 1932909199 and her current mailing address is 205 S Macdade Blvd Apt J, Glenolden, Pennsylvania. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1932909199.
Provider's Profile
| Full Name | Jessica Clark |
|---|
| Gender | Female |
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| Speciality | Licensed Practical Nurse |
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| Location | 205 S Macdade Blvd Apt J, Glenolden, Pennsylvania |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
NPI Data:
- NPI Number: 1932909199
- Provider Enumeration Date: 03/17/2025
- Last Update Date: 03/17/2025
Medical Identifiers
Medical identifiers for Jessica Clark such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
| 1932909199 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
| 164W00000X | Licensed Practical Nurse | PN307048 (Pennsylvania) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Jessica Clark is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
Jessica Clark, 205 S Macdade Blvd Apt J, Glenolden, PA 19036-2019 Ph: (215) 478-3207 | Jessica Clark, 205 S Macdade Blvd Apt J, Glenolden, PA 19036-2019 Ph: (215) 478-3207 |
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