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General NPI Number Information
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NPI Number | 1316298771
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Entity Type | Individual
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Provider Name | CHRISTINE ELAINE CLARKE APRN, FNP-C
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Gender | Female
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Dates
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Enumeration Date | 09/26/2012
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Last Update Date | 12/16/2021
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Provider Practice Location Address
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Address Line | 17080 HIGHWAY 3
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City | WEBSTER
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State | TX
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Zip | 77598-4129
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Country | US
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Telephone | 832-289-0509
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Fax |
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Provider Business Mailing Address
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Address Line | 781 DAVIS RD
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City | LEAGUE CITY
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State | TX
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Zip | 77573-2850
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Country | US
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Telephone | 832-289-0509
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 575249
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | AP122005
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License Number State | TX
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