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General NPI Number Information
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NPI Number | 1104122480
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Entity Type | Organization
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Legal Business Name | JP CLARKE AND ASSOCIATES,LLC
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Dates
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Enumeration Date | 02/02/2011
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Last Update Date | 04/03/2015
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Provider Practice Location Address
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Address Line | 8828 TELEGRAPH ROAD SUITE A
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City | ODENTON
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State | MD
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Zip | 21113-1130
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Country | US
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Telephone | 443-869-5791
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Fax | 443-646-0268
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Provider Business Mailing Address
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Address Line | 1011 HARLEM AVE
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City | BALTIMORE
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State | MD
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Zip | 21217-2429
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Country | US
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Telephone | 443-869-5791
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Fax | 443-646-0628
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Authorized Official
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Title or Position | CEO
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Name | MRS. JANET M PASSLEY-CLARKE
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Credential | CRNP-PMH
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Telephone | 443-869-5791
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State | MD
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