DR. JESSICA LYNN CLARK (NPI# 1962054387) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1962054387 |
| Entity Type | Individual |
| Full Name | DR. JESSICA LYNN CLARK |
| Credential | DNP, PMH-NP-BC |
| Practice Address |
7219 N Litchfield Rd Bldg 11302nd Luke Air Force Base AZ 85309-1529 |
| Mailing Address |
155 Reeves Rd Angola NY 14006-9077 |
| Practice Telephone | 6238567579 |
| Enumeration Date | 2019-07-16 |
| Last Update Date | 2019-07-16 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LP0808X |
Nurse Practitioner Specialization: Psych/Mental Health |
402755 | NY | Physician Assistants & Advanced Practice Nursing Providers |
| N | 171000000X | Military Health Care Provider | 402755 | NY | Other Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528690906 | Jessica Clark | Doula | 343 N Main Ave, Gresham, OR 97030-7246 | 2020-02-04 |
| 1568962306 | Jessica Lee Clark | Registered Nurse | 6011 Cielo Rnch, San Antonio, TX 78218-4161 | 2018-02-19 |
| 1811416076 | Jessica Clark | Counselor | 42189 Shadow Creek Ave, Gonzales, LA 70737-7241 | 2017-09-19 |
| 1124572821 | Jessica Clark | Specialist | 5664 Cahuenga Blvd, North Hollywood, CA 91601-2103 | 2016-08-10 |
| 1104286871 | Jessica Clark | Counselor | 2575 Westgate Bldg 2, Pendleton, OR 97801-9613 | 2016-02-24 |
| 1942612296 | Jessica Clark | Case Management | 620 John Austin Ln, Mt Washington, KY 40047-6354 | 2014-05-21 |
| 1154610269 | Jessica Clark | Social Worker | 55 Floyd Ave, Riverside, RI 02915-2927 | 2011-03-30 |
| 1346558780 | Jessica Clark | Dietitian, Registered | 187-191 Main Street, Ste 300, Emmaus, PA 18049-4017 | 2010-09-20 |
| 1760794309 | Jessica Michelle Clark | Dentist | 1300 Kempsville Rd Ste 5, Virginia Beach, VA 23464-6199 | 2010-07-12 |
| 1740449719 | Jessica Lynn Clark | Dermatology | 12139 Panama City Beach Pkwy, Panama City Beach, FL 32407-2609 | 2008-06-05 |
| Street Address |
7219 N LITCHFIELD RD BLDG 11302ND |
| City | LUKE AIR FORCE BASE |
| State | AZ |
| Zip Code | 85309-1529 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912466111 | Natalie Ann Korona | Nurse Practitioner | 56 Mdg/mdos/sgof, 7219 N. Litchfield Rd, Luke Afb, AZ 85309 | 2019-03-18 |
| 1558647024 | Cheng Chung Tsai | Pharmacist | 72 19 N Litchfield Road, 56 Medical Group, Luke Afb, AZ 85309 | 2011-10-28 |
| 1053617464 | Bradley William Snyder | Military Health Care Provider | 7224 North 139th Avenue, Glendale, AZ 85309 | 2011-02-02 |
| 1043516610 | Charles Delvon Pickett | Military Health Care Provider | 7019 N Litchfield Ave, Luke Afb, 56/amds, Luke Afb, AZ 85309 | 2011-01-31 |
| 1104980663 | Maurice Edgar Young | Obstetrics & Gynecology | 56th Aerospace Medicine Squadron, Luke Afb, AZ 85309 | 2006-12-20 |
| 1679658538 | Wayne Allen Beaver | Psychologist | Luke Air Force Base, Bldg 317, Glendale, AZ 85309 | 2006-10-26 |
| 1306945472 | 56th Medical Group Sgsl | Military/U.S. Coast Guard Pharmacy | Bldg 810, Luke Afb, AZ 85309 | 2006-09-22 |
| 1679676571 | Anita Glenn-reller | Counselor | 317 Lightning Ave, Luke Afb, AZ 85309 | 2006-09-06 |
| 1720402993 | Samuel Beck | Pediatrics | 7219 N Litchfield Rd, Luke Afb, AZ 85309 | 2014-02-09 |
| 1902162258 | Joshua Lemoyne Pringle | Surgery | 7219 N Litchfield Rd, Luke Afb, AZ 85309 | 2012-04-11 |
| Find all providers in zip 85309 | ||||
| Taxonomy Code | 363LP0808X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Psych/Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922608447 | Courtney Tafoya | Nurse Practitioner | 544 S 172nd Ave, Goodyear, AZ 85338-1281 | 2020-10-26 |
| 1215536479 | Yolanda D Baugh | Nurse Practitioner | 2625 W Piedmont Rd, Phoenix, AZ 85041-9540 | 2020-10-20 |
| 1871191593 | Lisa E Legg | Nurse Practitioner | 1480 E Pecos Rd Apt 3107, Gilbert, AZ 85295-1851 | 2020-10-14 |
| 1619584406 | Preston Strebeck | Nurse Practitioner | 3733 E Meadow Mist Ln, San Tan Valley, AZ 85140-5374 | 2020-09-25 |
| 1336754332 | Yvonne Maese | Nurse Practitioner | 824 N 99th Ave Ste 107-108, Avondale, AZ 85323-5324 | 2020-09-15 |
| 1306450960 | Williamsconsultant Com LLC | Nurse Practitioner | 2303 N 44th St Ste 12-1043, Phoenix, AZ 85008-2442 | 2020-09-01 |
| 1215549274 | Maria Graciela Cornejo | Nurse Practitioner | 3421 S Loback Ln, Gilbert, AZ 85297-7913 | 2020-08-20 |
| 1013529155 | Mark Skousen | Nurse Practitioner | 1745 W Western Dove Dr, Snowflake, AZ 85937-6185 | 2020-08-19 |
| 1356953699 | Rebecca Jane Turley | Nurse Practitioner | 1681 S Villas Ln, Chandler, AZ 85286-6805 | 2020-08-18 |
| 1467064063 | Dylan O'keefe Carey | Nurse Practitioner | 11702 W Fordson Dr, Marana, AZ 85653-7715 | 2020-08-17 |
| Find all providers with the same taxonomy | ||||
| City | LUKE AIR FORCE BASE |
| Zip Code | 85309 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.