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MS. JENNIFER LYNN PEACOCK CLARK
NPI 1962918417
Nurse Practitioner - Adult Health in Brooklyn, NY

Active since December 20, 2017
173 MESEROLE AVE APT 2L, BROOKLYN, NY 11222(646) 256-2104 Get Directions Write a Review

NPPES record last updated: March 3, 2021. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Mar 3, 2021, May 20, 2019, Dec 20, 2017 (3 updates tracked since 2017).

About Ms. Jennifer Lynn Peacock Clark NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MS. JENNIFER LYNN PEACOCK CLARK (NPI 1962918417) is an individual adult health provider in Brooklyn, New York, licensed in New York (308588) and active in the NPI registry since December 2017. She maintains a secondary practice location in New York.

NPPES Registry Identity

NPI1962918417
Entity TypeIndividualFemale
Primary Taxonomy363LA2200X
Provider Legal NameMS. JENNIFER LYNN PEACOCK CLARK
Location Address173 MESEROLE AVE APT 2LBrooklyn, NY 11222-2424
Mailing Address173 Meserole Ave Apt 2lBrooklyn, NY 11222-2424
Phone(646) 256-2104
Sole ProprietorYes
Enumeration DateDecember 20, 2017
Last NPPES UpdateMarch 3, 20213 updates tracked since enumeration
NPPES CertifiedMarch 3, 2021
✔ NPI 1962918417 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNurse Practitioner · Adult HealthPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LA2200X
License✔ Licensed in NY · 308588
Also ListedRegistered NurseTaxonomy 163W00000X · License 561419 (NY)
173 MESEROLE AVE APT 2L, Brooklyn, NY 11222
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Secondary Practice Location 1

Location 1220 E 42nd StNew York, NY 10017-5806 · Phone (646) 256-2104

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jennifer Clark's NPI number?

The NPI number for Jennifer Clark is 1962918417. It was assigned to this individual provider in the NPPES registry on December 20, 2017.

Where is Jennifer Clark located?

Jennifer Clark practices at 173 Meserole Ave Apt 2L, Brooklyn, NY 11222. The listed phone number is (646) 256-2104.

What is Jennifer Clark's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Adult Health, with taxonomy code 363LA2200X.

When was this NPI record last updated?

The NPPES record for Jennifer Clark was last updated on March 3, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.