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

Ebonique Clark

Individual provider Case Manager/Care Coordinator · NPI 1104247584

Ebonique Clark is a Case Manager/Care Coordinator in Jackson, Tennessee. Registered with an NPI since 2014.

In the registry since
2014

Practice location Address checks out

238 Summar Dr
Jackson, TN 38301-3906
Phone: (731) 541-8200
Fax: (731) 660-8739
Show map & directions

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

Specialties & licences

Case Manager/Care Coordinator (primary) Taxonomy 171M00000X

Record details

NPI number1104247584
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedJanuary 2, 2014
Last updated in NPPESJanuary 2, 2014

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