Provider Demographics
NPI:1053512178
Name:SANCLEMENTE, HARRIET (PNP)
Entity Type:Individual
Prefix:
First Name:HARRIET
Middle Name:
Last Name:SANCLEMENTE
Suffix:
Gender:F
Credentials:PNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8 ORGANUG RD
Mailing Address - Street 2:
Mailing Address - City:YORK
Mailing Address - State:ME
Mailing Address - Zip Code:03909-1306
Mailing Address - Country:US
Mailing Address - Phone:508-277-3389
Mailing Address - Fax:
Practice Address - Street 1:3 SHAPE DR
Practice Address - Street 2:
Practice Address - City:KENNEBUNK
Practice Address - State:ME
Practice Address - Zip Code:04043-6601
Practice Address - Country:US
Practice Address - Phone:207-467-8930
Practice Address - Fax:207-985-8459
Is Sole Proprietor?:No
Enumeration Date:2007-05-29
Last Update Date:2015-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA142120363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics