Clark, Jennifer S.

Clark, Jennifer S. is an individual health care provider with primary practice located at 500 Wind Ridge Dr. , Wausau WI 54401-4173. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as her primary health care specialty. Clark, Jennifer S. can be contacted via phone (715) 847-2611.

Contact Information

Primary practice address
500 Wind Ridge Dr. Wausau WI 54401-4173
Phone: (715) 847-2611
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 1648 Wisconsin

Profile Details

NPI number 1891721601
LBN Legal business name Clark, Jennifer S.
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 23rd, 2006
Last updated Dec 6th, 2010 - about 16 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1891721601 NPPES
Wisconsin Other 1648-023 WI STATE LICENSE

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