Jennifer Nicole Clark, ARNP, MSN

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

723513 Issued in FL

Practice address

11955 E Colonial Dr
Orlando, FL 32826-4725

Phone

(407) 281-4428

Fax

(407) 281-4437

NPI assigned

Aug 28, 2006

Last updated

Jul 8, 2007By 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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science - Nursing, Nurse Practitioner

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: jclark2859076@adventhealth.direct-ci.com

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

• The Healthcaring Clinic of Florida, LLC

  • Family Nurse Practitioner
  • Orange City, FL
  • NPI 1003914441
  NPD (past)

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

{
    "created_epoch": "1156723200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1548378706",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "795 LAKE ESTELLE DR",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328031235"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11955 E COLONIAL DR",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328264725",
            "telephone_number": "407-281-4428",
            "fax_number": "407-281-4437"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "JENNIFER",
        "middle_name": "NICOLE",
        "credential": "ARNP, MSN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-28",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "723513",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Denise S Clark, DO
• Elma Aseron Clark, CRNA
• Grace Catherine Clark, PHARMD, MPH
• Jan Ellen Clark
• Jenna Clark
• John Alfred Clark, O.D.
• Judith Yvette Clark, APRN
• Judy Quintero Clark, LCSW
• Kara Clark, RD
• Kristal Clark

• Family Nurse Practitioner in Orlando, FL
• Providers in Orlando, FL by specialty
• Family Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.