Provider Demographics
NPI:1376982850
Name:CHAMPLIN, LENA CLARICE (NP-C)
Entity Type:Individual
Prefix:
First Name:LENA
Middle Name:CLARICE
Last Name:CHAMPLIN
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1055 CEDAR CREEK RD
Mailing Address - Street 2:
Mailing Address - City:GREENEVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37743-2548
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:770-219-8440
Practice Address - Street 1:1150 NW 72ND AVE STE 455
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33126-1947
Practice Address - Country:US
Practice Address - Phone:352-584-7532
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-06-18
Last Update Date:2024-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN255639363LF0000X
AZ301115363LP0808X
FLARNP9288496363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLHO650WMedicare PIN
FLHO650VMedicare PIN
FLHO650YMedicare PIN