JENATTE VIRGINIA CLARK — Medicare Enrolled Provider (PRACTITIONER - NURSE PRACTITIONER, WA)
JENATTE VIRGINIA CLARK — Medicare Enrolled Provider (PRACTITIONER - NURSE PRACTITIONER, WA) is one of 9,000 enrolled providers in the MedicareEnroll dataset. Key details — Name: JENATTE VIRGINIA CLARK; Type: Individual; NPI: 1003250663.
| Name | JENATTE VIRGINIA CLARK |
|---|---|
| Type | Individual |
| NPI | 1003250663 |
| Provider type | PRACTITIONER - NURSE PRACTITIONER |
| State | WA |
| Enrollment ID | I20150205001543 |
| Multiple NPI flag | N |
| Source | CMS Medicare FFS Public Provider Enrollment (PECOS) |
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