| Doctor Name: | MRS. DENISE CLEGG |
| NPI Number: | 1801173505 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | FNP-BC |
| License Number: | 70489 |
| Business Practice Address: | 5258 Glow Dr Cross Lanes, WV - 253131173 |
| Business Phone Number: | 3047766783 |
| Business Fax Number: | |
| Mailing Address: | 5258 Glow Dr, CROSS LANES |
| State: | WV |
| Postal Code: | 253131173 |
| Phone Number: | 3047766783 |
| Fax Number: | |
| NPI Enumeration Date: | 11/08/2011 |
| NPI Last Update Date: | 11/08/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 364SF0001X |
| License Number: | 70489 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | WV |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Clinical Nurse Specialist |
| Taxonomy Specialization: | Family Health |
| Taxonomy Definition: | |