Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Jessica N Clark, ACNP-AG

Individual provider Gerontology Nurse Practitioner · NPI 1063138949

Jessica N Clark, ACNP-AG is a Nurse Practitioner in Cape Girardeau, Missouri. Qualified in 2022, 4 years ago. Practices with Southeast Missouri Hospital Physicians LLC, a 206-clinician group and accepts Medicare assignment. Licensed in Missouri.

Years since qualifying
4
Licensed in
MO
In the registry since
2022
Specialties on file
2

Practice location Address checks out

1701 Lacey St
Cape Girardeau, MO 63701-5230
Phone: (573) 331-6431
Fax: (573) 986-5984
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Acute Care Nurse Practitioner (primary) Taxonomy 363LA2100X · Licence 2016011887 (MO)
Gerontology Nurse Practitioner Taxonomy 363LG0600X · Licence 2016011887 (MO)

Record details

NPI number1063138949
Entity typeIndividual (Type 1)
GenderFemale
Credentials ACNP-AG
Sole proprietorNo
NPI enumeratedOctober 13, 2022
Last updated in NPPESOctober 13, 2022
Certification dateOctober 11, 2022

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2022 (4 years in practice)
Group practice Southeast Missouri Hospital Physicians Llc — 206 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Cape Girardeau