Provider Demographics
NPI:1689854473
Name:CLERKIN, ANNE MARY (RN)
Entity Type:Individual
Prefix:MRS
First Name:ANNE
Middle Name:MARY
Last Name:CLERKIN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20 ALLEN DR
Mailing Address - Street 2:
Mailing Address - City:WHITNEY POINT
Mailing Address - State:NY
Mailing Address - Zip Code:13862-1818
Mailing Address - Country:US
Mailing Address - Phone:607-692-3680
Mailing Address - Fax:
Practice Address - Street 1:20 ALLEN DR
Practice Address - Street 2:
Practice Address - City:WHITNEY POINT
Practice Address - State:NY
Practice Address - Zip Code:13862-1818
Practice Address - Country:US
Practice Address - Phone:607-692-3680
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-08
Last Update Date:2007-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY322280-1163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse