Individual
NICHOLAS BENJAMIN CLEMMONS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
818 TABBY LN, ATHENS, GA 30605-7058
(229) 449-4524
Mailing address
818 TABBY LN, ATHENS, GA 30605-7058
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
RN227788
GA
Other
Enumeration date
10/13/2021
Last updated
10/13/2021
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