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NPI Code Detail

MEDICARE: ASHLEE HUTCHESON CLARK APRN

MEDICARE: ASHLEE HUTCHESON CLARK APRN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LG0600XGerontology Nurse PractitionerAPRN11024014FL
2363LA2200XAdult Health Nurse PractitionerAPRN11024014FL
3363L00000XNurse PractitionerAPRN11024014FL
4363LG0600XGerontology Nurse Practitioner11024014FL

General Provider Information

NPI Number : 1811693252
Entity Type Code : Individual
Provider Name (Legal Business Name) : ASHLEE HUTCHESON CLARK APRN
Provider Business Mailing Address
First Line : PO BOX 746638
Second Line :
City : ATLANTA
State : GA
Zip : 30374-6638
Country : US
Telephone Number : 904-202-2092
Fax Number : 904-376-4075
Provider Business Practice Location Address
First Line : 820 PRUDENTIAL DR STE 304
Second Line :
City : JACKSONVILLE
State : FL
Zip : 32207-8205
Country : US
Telephone Number : 904-202-3860
Fax Number : 904-202-3846
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/07/2023
Last Update Date : 03/02/2026

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