Jenniffer Colleen Clark I
Individual provider Active NPI Case Manager/Care Coordinator · Grove, OK
NPI 1861996217 · NPPES record last updated Apr 23, 2018
Key facts
- NPI
- 1861996217
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Case Manager/Care Coordinator 171M00000X
- Practice address
- 1115 Har-Ber Rd
Grove, OK 74344 - Phone
- (918) 786-4434
- NPI assigned
- Mar 21, 2018
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Grand Lake Mental Health Center, Inc. | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Case Manager/Care Coordinator | 171M00000X | Yes |
Addresses
Primary practice location
1115 Har-Ber Rd
Grove, OK 74344
Mailing address
1115 Harbor Rd
Grove, OK 74344-7918
Phone (918) 786-4434
Other providers in Grove, OK
- James B Chapman
- Craig Michael Cheek
- CHI-Med Leasing, Inc.
- Charles Joseph Chouteau
- Maria A Cicio
- Lance Clark
- Rachel Megan Clark
- Keith Cockle
- Shaina Elizabeth Coffee
- Amber Rae Coker
All providers in Grove, OK · Case Manager/Care Coordinator in Oklahoma
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 23, 2018. 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.