Provider Demographics
NPI:1710437421
Name:CLEMENTS, LAUREN JAYNE (FNP - C)
Entity Type:Individual
Prefix:
First Name:LAUREN
Middle Name:JAYNE
Last Name:CLEMENTS
Suffix:
Gender:F
Credentials:FNP - C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6000 CAVE RIVER DR
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75093-6951
Mailing Address - Country:US
Mailing Address - Phone:214-538-5664
Mailing Address - Fax:
Practice Address - Street 1:6000 CAVE RIVER DR
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75093-6951
Practice Address - Country:US
Practice Address - Phone:214-538-5664
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-10-05
Last Update Date:2016-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP132153363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily