Provider Demographics
NPI:1851526735
Name:CLUTE, DOROTHEA MICHELE (APRN-NP, MSN, FNP-BC)
Entity Type:Individual
Prefix:MRS
First Name:DOROTHEA
Middle Name:MICHELE
Last Name:CLUTE
Suffix:
Gender:F
Credentials:APRN-NP, MSN, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2505 NORTH 24TH STREET
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68110
Mailing Address - Country:US
Mailing Address - Phone:402-451-5549
Mailing Address - Fax:402-502-0687
Practice Address - Street 1:6663 SORENSEN PKWY
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68152-2139
Practice Address - Country:US
Practice Address - Phone:402-453-6869
Practice Address - Fax:402-453-6768
Is Sole Proprietor?:No
Enumeration Date:2009-05-21
Last Update Date:2016-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE110926363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily