JESSICA LANE CLARK DNP PMHNP-BC NPI 1093387664

NPI Information

Jessica Lane Clark, DNP, PMHNP-BC is a psychiatric/mental health nurse practitioner in Athens, GA with 3 years of experience. Jessica Lane Clark, DNP, PMHNP-BC NPI is 1093387664. The provider is registered as an individual entity type and is a single specialty group.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

695 KINGS RD
ATHENS, GA
ZIP 30606-119
Phone: (706) 247-6029

The NPI 1093387664 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 7/13/2021 and was last updated on 4/25/2023.

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:

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