Provider Demographics
NPI:1386012938
Name:CLEMENTS, ROSANN PORRETTO (FNP-C)
Entity Type:Individual
Prefix:MRS
First Name:ROSANN
Middle Name:PORRETTO
Last Name:CLEMENTS
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:PROF
Other - First Name:ROSANN (ROSE)
Other - Middle Name:PORRETTO
Other - Last Name:CLEMENTS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:FNP-C
Mailing Address - Street 1:9710 CHAMPIONS COVE DR
Mailing Address - Street 2:
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77379-6532
Mailing Address - Country:US
Mailing Address - Phone:713-817-8689
Mailing Address - Fax:
Practice Address - Street 1:5603 FM 1960 RD W
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77069-4219
Practice Address - Country:US
Practice Address - Phone:866-389-2727
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-09-11
Last Update Date:2016-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP127918363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily