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General NPI Number Information
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NPI Number | 1942447974
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Entity Type | Individual
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Provider Name | MIRNA CLERIE PA-C
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Gender | Female
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Dates
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Enumeration Date | 01/13/2009
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Last Update Date | 07/14/2025
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Provider Practice Location Address
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Address Line | 5255 LOUGHBORO RD NW
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City | WASHINGTON
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State | DC
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Zip | 20016-2633
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Country | US
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Telephone | 202-537-4000
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Fax |
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Provider Business Mailing Address
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Address Line | 6201 GREENLEIGH AVE
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City | BALTIMORE
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State | MD
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Zip | 21220-2004
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Country | US
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Telephone | 410-933-6423
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | EL10207
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License Number State | NH
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Taxonomy #2
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | 012891
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License Number State | NY
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Taxonomy #3
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA200002214
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License Number State | DC
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