Healthcare Provider Details

I. General information

NPI: 1851955819
Provider Name (Legal Business Name): JODEAN CLARK FNP-C, AOCN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JODEAN LAPOINTE

II. Dates (important events)

Enumeration Date: 04/25/2019
Last Update Date: 04/06/2026
Certification Date: 04/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3426 N ROOSEVELT BLVD
KEY WEST FL
33040-4224
US

IV. Provider business mailing address

PO BOX 743144
ATLANTA GA
30374-3144
US

V. Phone/Fax

Practice location:
  • Phone: 786-596-2000
  • Fax: 786-279-7778
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAPRN11041589
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: