Individual
JOELLE TARA CLEMMER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
550 POPE AVE, MUNSON ARMY HEALTH CLINIC (ATTN: MCXN-COD, MS COTTON, FORT LEAVENWORTH, KS 66027-2332
(913) 684-6208
Mailing address
206 SWIFT ST, FORT LEAVENWORTH, KS 66027-1112
Taxonomy
Speciality
Code
Description
License number
State
163WC0400X
Case Management Registered Nurse
Primary
00126735
WA
Other
Enumeration date
08/05/2009
Last updated
08/05/2009
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