Doctor Name: | MRS. RONDA LEE CLEMENTS |
NPI Number: | 1891747531 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | APN |
License Number: | A01031 |
Business Practice Address: | 1050 W Free St Walnut Ridge, AR - 724761752 |
Business Phone Number: | 8708863201 |
Business Fax Number: | 8708861722 |
Mailing Address: | 1068 Third Ave, WALNUT RIDGE |
State: | AR |
Postal Code: | 724768433 |
Phone Number: | 8708865553 |
Fax Number: | 8708861722 |
NPI Enumeration Date: | 05/17/2006 |
NPI Last Update Date: | 09/14/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LX0001X |
License Number: | A01031 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | AR |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Obstetrics & Gynecology |
Taxonomy Definition: |