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Individual
MS. JENNIFER C CLEMENTE-METZ
Active
Individual
MS. JENNIFER C CLEMENTE-METZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C, M.S.
Taxonomy
Speciality
Code
Description
License number
State
207RA0401X
Addiction Medicine (Internal Medicine) Physician
10000891A
IN
363A00000X
Physician Assistant
Primary
10000891AB
IN
363A00000X
Physician Assistant
PA745
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10000891A
STATE LICENSE
IN
05
—
300006743
—
IN
01
—
IN3604007
MEDICARE INDIANA
IN
01
—
PA745
STATE LICENSE
KY
Enumeration date
12/11/2006
Last updated
11/08/2021
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