Provider Demographics
NPI:1578007381
Name:CLEMENS, ADRIENNE (NP)
Entity Type:Individual
Prefix:
First Name:ADRIENNE
Middle Name:
Last Name:CLEMENS
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:ADRIENNE
Other - Middle Name:
Other - Last Name:SMITH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:PO BOX 7527
Mailing Address - Street 2:
Mailing Address - City:DUBLIN
Mailing Address - State:OH
Mailing Address - Zip Code:43017-0727
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:807 FARSON ST STE 203A
Practice Address - Street 2:
Practice Address - City:BELPRE
Practice Address - State:OH
Practice Address - Zip Code:45714-1069
Practice Address - Country:US
Practice Address - Phone:740-401-1930
Practice Address - Fax:740-401-1937
Is Sole Proprietor?:No
Enumeration Date:2016-12-13
Last Update Date:2023-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH020266363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care