MS. JENNIFER LYNN PEACOCK CLARK NPI 1962918417

NPI Information

NPI: 1962918417
Provider Name: MS. JENNIFER LYNN PEACOCK CLARK
Classification: Nurse Practitioner - 363LA2200X
Entity Type: Individual

Specialization: Adult Health

PECOS Registration: Yes

Address:
173 MESEROLE AVE APT 2L
BROOKLYN, NY
ZIP 11222
Phone: (646) 256-2104
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MS. Jennifer Lynn Peacock Clark is an adult health nurse practitioner in Brooklyn, NY. MS. Jennifer Lynn Peacock Clark NPI is 1962918417. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

173 MESEROLE AVE APT 2L
BROOKLYN, NY
ZIP 11222-424
Phone: (646) 256-2104

The NPI 1962918417 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Power Mobility Devices.

The enumeration date for this NPI number is 12/20/2017 and was last updated on 3/3/2021.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	163W00000X	Registered Nurse		561419	NEW YORK	No
2	363LA2200X	Nurse Practitioner	Adult Health	308588	NEW YORK	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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