Provider Demographics
NPI:1740589027
Name:COUCH, CLAIRE A (ACNP, BC)
Entity Type:Individual
Prefix:MRS
First Name:CLAIRE
Middle Name:A
Last Name:COUCH
Suffix:
Gender:F
Credentials:ACNP, BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7545 VETERANS DR
Mailing Address - Street 2:
Mailing Address - City:RAMSEY
Mailing Address - State:MN
Mailing Address - Zip Code:55303-7500
Mailing Address - Country:US
Mailing Address - Phone:612-467-1100
Mailing Address - Fax:763-421-2390
Practice Address - Street 1:2 DUTCHESS CT
Practice Address - Street 2:
Practice Address - City:SARATOGA SPRINGS
Practice Address - State:NY
Practice Address - Zip Code:12866-9049
Practice Address - Country:US
Practice Address - Phone:518-583-0692
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-25
Last Update Date:2020-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF430061363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care