Provider Demographics
NPI:1811361041
Name:CLEMONS, STEVEN BLAKE (APRN)
Entity Type:Individual
Prefix:MR
First Name:STEVEN
Middle Name:BLAKE
Last Name:CLEMONS
Suffix:
Gender:M
Credentials:APRN
Other - Prefix:
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Mailing Address - Street 1:PO BOX 23229
Mailing Address - Street 2:
Mailing Address - City:OWENSBORO
Mailing Address - State:KY
Mailing Address - Zip Code:42304-3229
Mailing Address - Country:US
Mailing Address - Phone:270-688-1330
Mailing Address - Fax:270-688-1338
Practice Address - Street 1:912 WALLACE AVE STE 102
Practice Address - Street 2:
Practice Address - City:LEITCHFIELD
Practice Address - State:KY
Practice Address - Zip Code:42754-2405
Practice Address - Country:US
Practice Address - Phone:270-259-8888
Practice Address - Fax:270-259-8887
Is Sole Proprietor?:No
Enumeration Date:2015-11-27
Last Update Date:2023-07-27
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
KY3009788363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily