Provider Demographics
NPI:1750351060
Name:CLANON, ELAINE LYNETTE (CFNP)
Entity type:Individual
Prefix:MRS
First Name:ELAINE
Middle Name:LYNETTE
Last Name:CLANON
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Gender:F
Credentials:CFNP
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Mailing Address - Street 1:933 BRADBURY DR SE
Mailing Address - Street 2:SUITE 2222
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87106-4374
Mailing Address - Country:US
Mailing Address - Phone:505-272-3120
Mailing Address - Fax:505-272-8060
Practice Address - Street 1:1101 MEDICAL ARTS AVE NE
Practice Address - Street 2:BUILDING 2
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87102-2706
Practice Address - Country:US
Practice Address - Phone:505-272-6110
Practice Address - Fax:505-262-6112
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-26
Last Update Date:2012-05-17
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Provider Licenses
StateLicense IDTaxonomies
NMCNP00712363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily