Provider Demographics
NPI:1659871903
Name:CLARKSON, STEVEN JAMES (FNP)
Entity Type:Individual
Prefix:
First Name:STEVEN
Middle Name:JAMES
Last Name:CLARKSON
Suffix:
Gender:M
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2124 S SUSIE ST
Mailing Address - Street 2:
Mailing Address - City:BLOOMINGTON
Mailing Address - State:IN
Mailing Address - Zip Code:47403-3432
Mailing Address - Country:US
Mailing Address - Phone:812-219-5785
Mailing Address - Fax:
Practice Address - Street 1:300 S STATE ROAD 135 STE 310
Practice Address - Street 2:
Practice Address - City:GREENWOOD
Practice Address - State:IN
Practice Address - Zip Code:46142-1422
Practice Address - Country:US
Practice Address - Phone:317-497-2400
Practice Address - Fax:317-497-2515
Is Sole Proprietor?:No
Enumeration Date:2018-02-13
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN71007799A363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily