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General NPI Number Information
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NPI Number | 1821499310
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Entity Type | Individual
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Provider Name | JENNIFER LYNN CLEMMENS FNP
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Gender | Female
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Dates
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Enumeration Date | 09/16/2014
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Last Update Date | 11/11/2024
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Provider Practice Location Address
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Address Line | 6602 KNIGHTDALE BLVD STE 202
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City | KNIGHTDALE
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State | NC
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Zip | 27545-6526
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Country | US
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Telephone | 919-747-5270
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Fax | 919-747-5271
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Provider Business Mailing Address
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Address Line | 5221 PARAMOUNT PKWY STE 220
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City | MORRISVILLE
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State | NC
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Zip | 27560-5490
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Country | US
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Telephone | 984-215-3768
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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 | AP5472
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License Number State | AZ
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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 | 5017160
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License Number State | NC
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