Individual
TERRI L CLEMMONS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
110 E MESCALERO RD, ROSWELL, NM 88201-6542
(505) 623-1480
(505) 622-3325
Mailing address
PO BOX 1978, ROSWELL, NM 88202-1978
(505) 623-1480
(505) 622-3325
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
L15798
NM
Other
Enumeration date
08/31/2006
Last updated
05/01/2008
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