Jean A. Clark, RN, MS, CCRN, APRN

Primary specialty

Acute Care Nurse PractitionerTaxonomy code 363LA2100X

License

013011-23 Issued in NH

Practice address

1 Medical Center Dr
Lebanon, NH 03756-1000

Phone

(603) 650-7390

Fax

(603) 650-6346

NPI assigned

Jun 28, 2006

Last updated

Jul 29, 2009By 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 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science, Nurse Practitioner, Registered Nurse

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

{
    "created_epoch": "1151452800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1248825600000",
    "number": "1518994078",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 MEDICAL CENTER DR",
            "city": "LEBANON",
            "state": "NH",
            "postal_code": "037561000",
            "telephone_number": "603-650-7390",
            "fax_number": "603-650-6346"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 MEDICAL CENTER DR",
            "city": "LEBANON",
            "state": "NH",
            "postal_code": "037561000",
            "telephone_number": "603-650-7390",
            "fax_number": "603-650-6346"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "JEAN",
        "middle_name": "A.",
        "name_prefix": "Ms.",
        "credential": "RN, MS, CCRN, APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-28",
        "last_updated": "2009-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "NH",
            "license": "013011-23",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30340591",
            "state": "NH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0NP2131",
            "state": "VT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• William J Cioffredi, PT
• City of Lebanon
• Robin R Clark-Arbogast, MS APRN
• Cantwell Clark V, MD
• James Kenneth Seffinga Clark, M.D.
• Jeffrey Allen Clark, M.D.
• Jenna Clark, MD
• Kelly Fisher Clark, OT
• Kristin D Clark, CRNA
• Sarah Ashley Clark

• Acute Care Nurse Practitioner in Lebanon, NH
• Providers in Lebanon, NH by specialty
• Acute Care Nurse Practitioner in New Hampshire

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2009; 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.