Jeanette Marie Clark, APRN

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

334234 Issued in AZ

Practice address

3811 E Bell Rd Ste 111
Phoenix, AZ 85032-2158

Phone

(208) 270-2178

NPI assigned

Jul 28, 2025

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AZ

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2025

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Pain and Palliative Associates of Arizona

  • Pain Medicine Physician
  • Phoenix, AZ
  • NPI 1538723531
  Medicare reassignment NPD
• Valley Geriatric Associates PLLC

  • Geriatric Medicine (Family Medicine) Physician
  • Phoenix, AZ
  • NPI 1063127306
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1753660800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1771286400000",
    "number": "1265315154",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24611 N 144TH AVE",
            "city": "SURPRISE",
            "state": "AZ",
            "postal_code": "853877033",
            "telephone_number": "208-270-2178"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3811 E BELL RD STE 111",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850322158",
            "telephone_number": "208-270-2178"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "JEANETTE",
        "middle_name": "MARIE",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-07-28",
        "last_updated": "2026-02-17",
        "certification_date": "2026-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "AZ",
            "license": "334234",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Edith Mary Clark, MBA, RD, CDE
• Erin Clark
• Jace Anthony Clark, PHARMD
• James Clark, MD
• James Edward Clark
• Jhameca Clark
• Joanna J Clark, M.S., CCC-SLP
• Jody R Clark
• Justin Clark, PA-C
• Justin John Clark, PHARMD

• Adult Health Nurse Practitioner in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Adult Health Nurse Practitioner in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.