SearchMaryland171M00000X

Jettanna Burruss- Clark

NPI 1902590227 · on the registry since 2023 · sole proprietor

Practice

Address
22 Meadow Pl
Waldorf, MD 20601
Phone
(240) 810-3952

Registry record

Primary taxonomy
171M00000X
171M00000X
Also registered as
101Y00000X
172V00000X
Sex
Female
Record last updated
2026-02-11

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Maryland