Provider Demographics
NPI:1013351295
Name:CLOWDSLEY, RENEA KATHLEEN (APRN)
Entity type:Individual
Prefix:MRS
First Name:RENEA
Middle Name:KATHLEEN
Last Name:CLOWDSLEY
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:6 OCEAN VIEW DR
Mailing Address - Street 2:
Mailing Address - City:PENSACOLA BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32561-2436
Mailing Address - Country:US
Mailing Address - Phone:850-384-6256
Mailing Address - Fax:
Practice Address - Street 1:1101 GULF BREEZE PKWY STE 14
Practice Address - Street 2:
Practice Address - City:GULF BREEZE
Practice Address - State:FL
Practice Address - Zip Code:32561-4892
Practice Address - Country:US
Practice Address - Phone:850-990-9100
Practice Address - Fax:850-396-0142
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-18
Last Update Date:2023-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN9247184363LF0000X
FLARNP9247184363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily