Jacki Shehan Clark
Individual provider Active NPI Case Manager/Care Coordinator · Starke, FL
NPI 1730795477 · NPPES record last updated Sep 18, 2020
Key facts
- NPI
- 1730795477
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Case Manager/Care Coordinator 171M00000X
- Practice address
- 945 Grand St
Starke, FL 32091-1821 - Phone
- (904) 964-8382
- NPI assigned
- Sep 18, 2020
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Case Manager/Care Coordinator | 171M00000X | Yes |
Addresses
Primary practice location
945 Grand St
Starke, FL 32091-1821
Mailing address
4300 SW 13TH St
Gainesville, FL 32608-4006
Phone (352) 374-5600
Other providers in Starke, FL
- Cardiolog Associates of Gainesville
- Cardiology Associates of Gainesville
- Jessica Luckado Caveny
- Jerome V Cerdan
- Childrens Home Society
- Tricia Lawson Clark
- Angela Coggins-Anderson
- Susan Dianne Colby
- Thomas Joseph Collins
- Shecara Coney
All providers in Starke, FL · Case Manager/Care Coordinator in Florida
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 18, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.