Provider Demographics
NPI:1205056330
Name:CLEMENT, EUGENIE MARIANNE (RNC WHCNP MS)
Entity type:Individual
Prefix:
First Name:EUGENIE
Middle Name:MARIANNE
Last Name:CLEMENT
Suffix:
Gender:F
Credentials:RNC WHCNP MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:7424 GREENVILLE AVE
Mailing Address - Street 2:SUITE 206
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75231-4534
Mailing Address - Country:US
Mailing Address - Phone:214-363-2004
Mailing Address - Fax:214-696-2091
Practice Address - Street 1:7424 GREENVILLE AVE
Practice Address - Street 2:SUITE 206
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75231-4534
Practice Address - Country:US
Practice Address - Phone:214-363-2004
Practice Address - Fax:214-696-2091
Is Sole Proprietor?:No
Enumeration Date:2007-04-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TX219951363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health