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General NPI Number Information
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NPI Number | 1902310386
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Entity Type | Individual
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Provider Name | DANIKA CLEMMONS NP
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Gender | Female
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Dates
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Enumeration Date | 11/21/2017
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Last Update Date | 04/29/2020
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Provider Practice Location Address
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Address Line | 9408 WILLOW GROVE PL
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City | CHESTERFIELD
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State | VA
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Zip | 23832-9273
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Country | US
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Telephone | 180-439-7168
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Fax | 804-397-1680
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Provider Business Mailing Address
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Address Line | 1101 SAM PERRY BLVD STE 411
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City | FREDERICKSBURG
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State | VA
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Zip | 22401-4466
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Country | US
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Telephone | 540-741-7846
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Fax | 540-741-1632
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 0024175602
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License Number State | VA
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