Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363L00000X | Nurse Practitioner | RN342711L | PA |
N | 363LA2100X | Nurse Practitioner - Acute Care | RN342711L | PA |
NPI | 1003829805 |
---|---|
Provider Name | Ms. Carla Patrice Clements |
First Address | Mantua, NJ 08051-2282 |
Second Address | Philadelphia, PA 19104-4551 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/08/2006 |
Last Update Date | 08/07/2007 |