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Individual

MS. JENNIFER C CLEMENTE-METZ

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PA-C, M.S.

Contact information

Practice address
1802 E 10TH ST, JEFFERSONVILLE, IN 47130-6016
(812) 288-2488
(770) 573-9513
Mailing address
2100 MARKET ST STE 101, CHARLESTOWN, IN 47111-9535
(812) 503-5100
(770) 573-9513

Taxonomy

Speciality
Code
Description
License number
State
207RA0401X
Addiction Medicine (Internal Medicine) Physician
10000891A
IN
363A00000X
Physician Assistant
Primary
10000891AB
IN
363A00000X
Physician Assistant
PA745
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
10000891A
STATE LICENSE
IN
05
300006743
IN
01
IN3604007
MEDICARE INDIANA
IN
01
PA745
STATE LICENSE
KY
Enumeration date
12/11/2006
Last updated
11/08/2021
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