Provider Demographics
NPI:1346314036
Name:CLEMENTS, SANDRA D (RN)
Entity Type:Individual
Prefix:MS
First Name:SANDRA
Middle Name:D
Last Name:CLEMENTS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
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Mailing Address - Street 1:4142 OAK CREST DR
Mailing Address - Street 2:
Mailing Address - City:TUCKER
Mailing Address - State:GA
Mailing Address - Zip Code:30084-7521
Mailing Address - Country:US
Mailing Address - Phone:404-778-3444
Mailing Address - Fax:404-778-4216
Practice Address - Street 1:1365 CLIFTON RD NE
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30322-1013
Practice Address - Country:US
Practice Address - Phone:404-778-3444
Practice Address - Fax:404-778-4216
Is Sole Proprietor?:No
Enumeration Date:2006-11-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GARN031399163WN0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WN0800XNursing Service ProvidersRegistered NurseNeuroscience