Provider Demographics
NPI:1134735723
Name:CASE, CLARENCE DONALD JR (APRN)
Entity type:Individual
Prefix:
First Name:CLARENCE
Middle Name:DONALD
Last Name:CASE
Suffix:JR
Gender:M
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:153 ARLINGTON PARK COURT
Mailing Address - Street 2:
Mailing Address - City:HOT SPRINGS
Mailing Address - State:AR
Mailing Address - Zip Code:71901
Mailing Address - Country:US
Mailing Address - Phone:501-701-3076
Mailing Address - Fax:
Practice Address - Street 1:2110 HIGDON FERRY RD STE C
Practice Address - Street 2:
Practice Address - City:HOT SPRINGS
Practice Address - State:AR
Practice Address - Zip Code:71913-7288
Practice Address - Country:US
Practice Address - Phone:501-701-3076
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-18
Last Update Date:2025-05-14
Deactivation Date:2021-02-08
Deactivation Code:
Reactivation Date:2021-06-22
Provider Licenses
StateLicense IDTaxonomies
CT11746363LP0808X
KS00000363LP0808X
AR230743363LP0808X
WA61281547363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health