IndividualActive
Jennifer Clark, NURSE PRACTITIONER
NPI 1265661045 · Family Nurse Practitioner · Gray, GA
Provider details
- NPI number
- 1265661045
- Entity type
- Individual
- Primary specialty
- Family Nurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers
- Credential
- NURSE PRACTITIONER
- Sex
- Female
- Sole proprietor
- No
- License
- RN173733 (GA)
Specialties & taxonomies
Physician Assistants & Advanced Practice Nursing Providers
Practice location
1005 Boulder Dr
Gray, GA 31032
Phone: (478) 621-2100
Fax: (478) 744-0481
Approximate (ZIP-level) locationGet directions
Mailing address
1005 Boulder Dr
Gray, GA 31032-6141
Additional practice locations (1)
- 315 W 10th St NeRome, GA 30165-2676Phone: (706) 234-1334
Registry dates
- Enumerated
- 2009-07-14
- Last updated
- 2019-07-17
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.