Provider Demographics
NPI:1326491101
Name:CLARKE, CLAUDETTE ELORENE (ARNP)
Entity Type:Individual
Prefix:
First Name:CLAUDETTE
Middle Name:ELORENE
Last Name:CLARKE
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:CLAUDETTE
Other - Middle Name:ELORENE
Other - Last Name:NELSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:975 BAPTIST WAY
Mailing Address - Street 2:
Mailing Address - City:HOMESTEAD
Mailing Address - State:FL
Mailing Address - Zip Code:33033-7600
Mailing Address - Country:US
Mailing Address - Phone:786-243-8073
Mailing Address - Fax:786-576-0471
Practice Address - Street 1:975 BAPTIST WAY
Practice Address - Street 2:
Practice Address - City:HOMESTEAD
Practice Address - State:FL
Practice Address - Zip Code:33033-7600
Practice Address - Country:US
Practice Address - Phone:786-243-8073
Practice Address - Fax:786-576-0471
Is Sole Proprietor?:No
Enumeration Date:2016-07-18
Last Update Date:2021-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9268832163W00000X
FLARNP9268832363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse