Provider Demographics
NPI:1134460561
Name:CLEMENT, JULIE MARIE (PA-C)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:MARIE
Last Name:CLEMENT
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6115 W YORKTOWN WAY
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:AZ
Mailing Address - Zip Code:85132-7514
Mailing Address - Country:US
Mailing Address - Phone:480-550-1751
Mailing Address - Fax:
Practice Address - Street 1:971 JASON LOPEZ CIR STOP B
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:AZ
Practice Address - Zip Code:85132-2502
Practice Address - Country:US
Practice Address - Phone:520-868-7013
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-03-11
Last Update Date:2013-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant