Individual
MR. BILLY KENNETH CLEM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
33205 FAIRFIELD RD, LEWES, DE 19958-5407
(302) 945-1085
Mailing address
33205 FAIRFIELD RD, LEWES, DE 19958-5407
(302) 945-1085
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
L1-0021741
DE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0000967738
—
DE
Enumeration date
01/05/2007
Last updated
07/09/2007
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