Provider Demographics
NPI:1184869992
Name:CLARKE, ELIZABETH MELISSA (ARNP)
Entity type:Individual
Prefix:MISS
First Name:ELIZABETH
Middle Name:MELISSA
Last Name:CLARKE
Suffix:
Gender:F
Credentials:ARNP
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Mailing Address - Street 1:4300 W LAKE MARY BLVD
Mailing Address - Street 2:SUITE 1010-357
Mailing Address - City:LAKE MARY
Mailing Address - State:FL
Mailing Address - Zip Code:32746-2060
Mailing Address - Country:US
Mailing Address - Phone:407-732-7957
Mailing Address - Fax:407-732-7925
Practice Address - Street 1:1715 SHARON RD W
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28210-5663
Practice Address - Country:US
Practice Address - Phone:704-944-0650
Practice Address - Fax:407-732-7925
Is Sole Proprietor?:No
Enumeration Date:2008-12-08
Last Update Date:2016-10-18
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NC5009015363LF0000X
FLARNP9362590363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily