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NPI Code Detail

MEDICARE: MS. EARNESTINE GAINER-CLEMENTS ED.S.

MEDICARE:  MS. EARNESTINE  GAINER-CLEMENTS  ED.S.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1104100000XSocial Worker

General Provider Information

NPI Number : 1730433921
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. EARNESTINE GAINER-CLEMENTS ED.S.
Provider Business Mailing Address
First Line : 1841 MALLARD DR
Second Line :
City : PANAMA CITY
State : FL
Zip : 32404-2951
Country : US
Telephone Number : 850-874-1387
Fax Number :
Provider Business Practice Location Address
First Line : 1122 JENKS AVE
Second Line :
City : PANAMA CITY
State : FL
Zip : 32401-2439
Country : US
Telephone Number : 850-683-1887
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/09/2012
Last Update Date : 11/09/2012

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Directions to “ MS. EARNESTINE GAINER-CLEMENTS ED.S.” Practice Location

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