Individual
PATRICE CLEMENS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
54 CINQUE LN, BAYPORT, NY 11705-1215
(631) 672-1563
Mailing address
54 CINQUE LN, BAYPORT, NY 11705-1215
(631) 672-1563
Taxonomy
Speciality
Code
Description
License number
State
163WH0200X
Home Health Registered Nurse
Primary
82034901
NY
164W00000X
Licensed Practical Nurse
294968-1
NY
Other
Enumeration date
01/05/2018
Last updated
11/16/2021
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