Doctor Name: | LAUREN CLEMENT |
NPI Number: | 1215309984 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | ARNP-C |
License Number: | 2015037590 |
Business Practice Address: | 4308 Dianna Ln Wentzville, MO - 633856242 |
Business Phone Number: | 8168961717 |
Business Fax Number: | |
Mailing Address: | 4308 Dianna Ln, WENTZVILLE |
State: | MO |
Postal Code: | 633856242 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 10/21/2015 |
NPI Last Update Date: | 12/08/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | 2015037590 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MO |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |