Provider Demographics
NPI:1083175665
Name:CLEMENT, JULIE CHRISTINE (APRN)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:CHRISTINE
Last Name:CLEMENT
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3914 E STATE ROAD 64
Mailing Address - Street 2:
Mailing Address - City:BRADENTON
Mailing Address - State:FL
Mailing Address - Zip Code:34208-9059
Mailing Address - Country:US
Mailing Address - Phone:941-216-3800
Mailing Address - Fax:941-216-3703
Practice Address - Street 1:3914 E STATE ROAD 64
Practice Address - Street 2:
Practice Address - City:BRADENTON
Practice Address - State:FL
Practice Address - Zip Code:34208-9059
Practice Address - Country:US
Practice Address - Phone:941-216-3800
Practice Address - Fax:941-221-6370
Is Sole Proprietor?:No
Enumeration Date:2019-03-27
Last Update Date:2023-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11000561363LA2200X, 363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology