Provider Demographics
NPI:1558330696
Name:ARMSTRONG, CLARA LA VERNE (RN, NP)
Entity Type:Individual
Prefix:MISS
First Name:CLARA
Middle Name:LA VERNE
Last Name:ARMSTRONG
Suffix:
Gender:F
Credentials:RN, NP
Other - Prefix:MRS
Other - First Name:CLARA
Other - Middle Name:LA VERNE
Other - Last Name:ARMSTRONG-EDWARDS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RN, NP
Mailing Address - Street 1:49 E 90TH ST
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60619-6732
Mailing Address - Country:US
Mailing Address - Phone:773-723-7944
Mailing Address - Fax:
Practice Address - Street 1:820 S DAMEN AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60612-3728
Practice Address - Country:US
Practice Address - Phone:312-569-8387
Practice Address - Fax:312-569-6110
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health