- Practice location
- 173 Meserole Ave Apt 2L, Brooklyn, NY 11222-2424
- Phone
- 646-256-2104
- Fax
- —
- Last updated
- March 3, 2021
Jennifer Lynn Peacock Clark is a Nurse Practitioner, Adult Health based in Brooklyn, NY. Jennifer Lynn Peacock Clark practices in Brooklyn, NY. The NPI Number for Jennifer Lynn Peacock Clark is 1962918417 and holds a License No. 561419 (NY). The current practice location address for Jennifer Lynn Peacock Clark is 173 Meserole Ave Apt 2L, Brooklyn, NY 11222-2424 and can be reached out via phone at 646-256-2104.
Provider Profile Details
- NPI Number
- 1962918417
- Provider Name
- Jennifer Lynn Peacock Clark
- Provider Entity Type
- Individual
- Gender
- Female
- Address
- 173 Meserole Ave Apt 2L, Brooklyn, NY 11222-2424
- Phone Number
- 646-256-2104
- Primary Taxonomy
- Nurse Practitioner, Adult Health · 363LA2200X
- Sole Proprietor
- Yes
- Provider Enumeration Date
- December 20, 2017
- Last Update Date
- March 3, 2021
- Certification Date
- March 3, 2021
- NPI Status
- Active
Provider Business Practice Location Address Details
- Address
- 173 Meserole Ave Apt 2L
Brooklyn, NY 11222-2424 - City
- Brooklyn
- State
- New York
- Zip
- 11222-2424
- Phone Number
- 646-256-2104
Provider Business Mailing Address Details
- Address
- 173 Meserole Ave Apt 2L
Brooklyn, NY 11222-2424 - City
- Brooklyn
- State
- NY
- Zip
- 11222-2424
License Information
- License Number (1)
- 561419
- License State (1)
- NY
- Taxonomy (1)
- Registered Nurse · 163W00000X
- License Number (2)
- 308588
- License State (2)
- NY
- Taxonomy (2)
- Nurse Practitioner, Adult Health · 363LA2200X · Primary
Legacy Identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| No legacy identifiers (Medicaid, Medicare or plan IDs) are on file for this provider. | |||
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Frequently Asked Questions
What is the NPI number of Ms. Jennifer L Clark?
The NPI number of Ms. Jennifer L Clark is 1962918417. It was assigned on December 20, 2017 and is currently active in the NPPES registry.
What is the specialty of Ms. Jennifer L Clark?
Ms. Jennifer L Clark is registered under the primary taxonomy Nurse Practitioner, Adult Health (code 363LA2200X), licensed in NY under license number 561419.
Where does Ms. Jennifer L Clark practice?
The practice location is 173 Meserole Ave Apt 2L, Brooklyn, NY 11222-2424. The office can be reached at 646-256-2104 (phone).
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). It is used in HIPAA standard transactions.
How do I verify this NPI record?
This record is sourced from the public NPPES NPI Registry maintained by CMS. You can confirm it by searching NPI 1962918417 directly on the NPPES registry website.