person
Jessica Autumn Clark
Student in an Organized Health Care Education/Training Program in Tupelo, Mississippi
NPI 1104560317

Jessica Autumn Clark is a Student in an Organized Health Care Education/Training Program based in Smyrna, MS. Jessica Autumn Clark practices in Tupelo, MS. The NPI Number for Jessica Autumn Clark is 1104560317 and holds a License No. (Mississippi).

The current practice location address for Jessica Autumn Clark is 860 S Madison St, Tupelo, MS and can be reached out via phone at 615-513-4978.

Location: 860 S Madison St, Tupelo, MS, 37167-5249
person
Provider Profile Details
NPI Number
1104560317
Provider Name
Jessica Autumn Clark
Credential
Provider Entity Type
Individual
Gender
Female
Address
860 S Madison St, Tupelo, MS, 37167-5249
Phone Number
615-513-4978
Fax Number
Provider Enumeration Date
04/24/2022
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
860 S Madison St
City
State
Zip
38801-4905
Phone Number
615-513-4978
Fax Number
person
Provider Business Mailing Address Details
Address
860 S Madison St
City
State
Zip
38801-4905
Phone Number
615-513-4978
Fax Number
person
Provider's Taxonomy Details 1
Type
Student, Health Care
Classification
Student in an Organized Health Care Education/Training Program
Speciality
-
Taxonomy
License No.
(Mississippi)
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
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