Jennifer Faye Clark, R.N.

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

165443 Issued in TN

Practice address

255 E Watt St
Alcoa, TN 37701-2236

Phone

(865) 273-1616

Fax

(865) 273-1645

NPI assigned

Apr 29, 2013

Last updated

Jun 17, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

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

{
    "created_epoch": "1367193600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623888000000",
    "number": "1407290885",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1923 SULPHUR SPRINGS RD DEPT 100",
            "city": "MORRISTOWN",
            "state": "TN",
            "postal_code": "378135654",
            "telephone_number": "423-317-9344",
            "fax_number": "423-714-2355"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "255 E WATT ST",
            "city": "ALCOA",
            "state": "TN",
            "postal_code": "377012236",
            "telephone_number": "865-273-1616",
            "fax_number": "865-273-1645"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "JENNIFER",
        "middle_name": "FAYE",
        "credential": "R.N.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-04-29",
        "last_updated": "2021-06-17",
        "certification_date": "2021-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "TN",
            "license": "165443",
            "primary": true
        },
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "TN",
            "license": "RN165443",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rhonda D Ciszewski, MD
• K Darrel Clagough, DDS
• Aaron Christopher Clark, DPH
• Dewey Lee Clark, D.PH.
• Douglas E Clark, PHARMD.
• Callie Clement, DPT
• Lauren E. Cline, M.D.
• Diana L Cobb, M.D.
• Ashley Renee Cochran, PTA
• Whitney Elan Colella, PA-C

• Registered Nurse in Alcoa, TN
• Providers in Alcoa, TN by specialty
• Registered Nurse in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.