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General NPI Number Information
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NPI Number | 1528725157
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Entity Type | Individual
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Provider Name | JENNIFER DANIELLE CLARY MSN, FNP-C
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Gender | Female
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Dates
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Enumeration Date | 11/18/2021
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Last Update Date | 12/07/2024
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Provider Practice Location Address
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Address Line | 701 N MAIN ST
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City | EMPORIA
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State | VA
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Zip | 23847-1274
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Country | US
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Telephone | 434-336-3199
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Fax |
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Provider Business Mailing Address
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Address Line | 445 CHARLES H DIMMOCK PKWY STE 100
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City | COLONIAL HEIGHTS
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State | VA
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Zip | 23834-2990
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Country | US
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Telephone | 804-520-1764
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 0024183163
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License Number State | VA
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