Provider Demographics
NPI:1740093830
Name:BEFOUNE CLARK, JENNIFER AKOYOKO ANGELINE
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:AKOYOKO ANGELINE
Last Name:BEFOUNE CLARK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14140 84TH DR APT 5J
Mailing Address - Street 2:
Mailing Address - City:JAMAICA
Mailing Address - State:NY
Mailing Address - Zip Code:11435-2403
Mailing Address - Country:US
Mailing Address - Phone:727-831-5565
Mailing Address - Fax:
Practice Address - Street 1:14140 84TH DR APT 5J
Practice Address - Street 2:
Practice Address - City:JAMAICA
Practice Address - State:NY
Practice Address - Zip Code:11435-2403
Practice Address - Country:US
Practice Address - Phone:727-831-5565
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-31
Last Update Date:2025-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY806605163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse